Psychometric Evaluation of Paediatric Patients with Central Nervous System Demyelination

Abstract

Background: Psychosocial evaluation in patients with demyelinating diseases has been predominantly examined in adults. Only a few studies were conducted on children with demyelinating diseases to study neuropsychiatric impairment.Aim: to assess the neuropsychiatric comorbidities and behavioural problems in children with central nervous system (CNS) demyelinating diseases, as well as to determine the effect of these comorbidities on the quality of life (QoL).Methods: this is a case-control study that was done during the period from December 2022 till june 2023, the patients were randomly selected from child neurology clinic, faculty of medicine, Ain Shams University Hospital. This study included twenty-eight children diagnosed with CNS demyelination as well as 28 healthy children with matched age, sex, and social class were enrolled in this study as a control. The neuropsychiatric evaluation was performed by clinical examination and three psychometric scales : (1) Kiddie-Schedule for Affective Disorders and Schizophrenia (K-SADS) (2) Child Behaviour Checklist (CBCL) (3) Kid-Screen 27. The assessments were conducted between 1 and 18 months (median 8 months) after the acute illness.Results: There were clinically significant anxiety in 64.3%, and depressive symptoms in 93%. Impaired attention was detected in 17.9% of the patients. Patients with demyelination experienced more behavioural problems than control, the CBCL internalizing and externalizing symptoms scores were in the clinical range for 85.7%, 42.9% of the participants, Patients with demyelination had lower scores for QoL than control (P= 0.001). Psychological comorbidities such as depression, anxiety, attention problems, and oppositional defiant were the main determinants for low QoL.Conclusion: neuropsychiatric symptoms and behavioural problems are not uncommon among paediatric patients with CNS demyelinating disorders. Our data showed that demyelination diseases might have mental health sequelae long after the resolution of the acute attack which has a deleterious effect on quality of life.