Symptoms of anxiety and depression in school-aged children with active epilepsy: A population-based study

Reilly, Colin; Atkinson, Patricia; Chin, Richard; Das, Krishna; Gillberg, Christopher; Aylett, Sarah; Burch, Victoria; Scott, Rod C.; Neville, Brian

doi:10.1016/j.yebeh.2015.09.004

Cited by 27 publications

(23 citation statements)

References 40 publications

(52 reference statements)

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“…The majority of participants in our study received treatment with at least one AED, and just 6 percent received no AED. This is comparable to previous studies that included 2 percent to 23 percent of participants not receiving an AED at the time of those studies . This suggests that the lower prevalence of symptoms of depression identified in our study is unlikely to be because of lower seizure severity.…”

Section: Discussionsupporting

confidence: 87%

Longitudinal trajectories of depression symptoms in children with epilepsy

Rosic

Avery²,

Streiner

et al. 2019

Develop Med Child Neuro

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Aim To examine self‐ and proxy‐reported symptoms of depression in children with epilepsy. Method This was a prospective longitudinal cohort study of children with epilepsy. Participants were treated at six Canadian tertiary‐care centers and followed over 28 months with repeated assessments of child self‐reported symptoms of depression using the Children’s Depression Inventory Short‐Form (CDI‐S). Trajectories of symptoms of depression were estimated using linear mixed effects (LME) modeling. Results At baseline, 477 children had complete data (mean age [SD] 11y 5mo [2y 1mo], range 7y 7mo–15y 1mo; 234 females, 243 males). Mean CDI‐S T score at baseline was 45.7 (SD=7.5) and at 28 months was 44.9 (SD=8.2), both were within the ‘average’ range. Results from LME modeling revealed mean raw CDI‐S score of 1.897, corrected for age 10 years (corresponding to T scores slightly below the normed mean of 50), with no significant change over three measurements (slope=–0.113, p=0.135), indicating that CDI‐S scores were stable over 28 months. Children with high initial CDI‐S scores had lower subsequent scores, as demonstrated by the correlation of –0.827 between intercept and slope (p<0.001). Parents reported comparable findings. Interpretation Self‐ and proxy‐reported symptoms of depression were generally low and stable over an extended follow‐up period. Normalization of scores was seen upon repeated assessment, even in children with higher scores of symptoms of depression at one point. These findings speak to the value and importance of repeated assessment over time. What this paper adds In children with epilepsy, self‐ and proxy‐reported symptoms of depression were generally low and stable over 28 months. The trajectory of symptoms of depression was not associated with seizure severity, whether considering the frequency or type of seizures. Parents’ reports of symptoms of depression were comparable to the children’s self‐evaluations.

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Section: Discussionsupporting

confidence: 87%

Longitudinal trajectories of depression symptoms in children with epilepsy

Rosic

Avery²,

Streiner

et al. 2019

Develop Med Child Neuro

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“…Few studies have employed disorder‐specific checklists, and thus there is a need to use screening instruments for ADHD, oppositional defiant disorder, autism, depression, and anxiety, the most common comorbid behavioral and emotional difficulties in the pediatric epilepsy population, to better understand whether there are differences in changes according to the assessed domain. There is also a need to use self‐reports and teacher reports, given that these respondents can often differ significantly from parental reports of psychopathology in children with epilepsy . It is additionally important that appropriate validated instruments are used with respect to child age and intellectual functioning.…”

Section: Discussionmentioning

confidence: 99%

“…There is also a need to use self-reports and teacher reports, given that these respondents can often differ significantly from parental reports of psychopathology in children with epilepsy. 36,37 It is additionally important that appropriate validated instruments are used with respect to child age and intellectual functioning. Future studies will also be more robust if assessors of functioning are blind to a child's surgical status and/or preoperative behavioral functioning if possible.…”

Section: Implications For Clinical Practice and Future Researchmentioning

confidence: 99%

Do behavior and emotions improve after pediatric epilepsy surgery? A systematic review

et al. 2019

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Objective The objective was to systematically review studies that have focused on behavioral and emotional functioning before (baseline) and after (follow‐up) pediatric epilepsy surgery. Methods The systematic review was carried out according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analyses) guidelines. PubMed and EMBASE were searched from inception. Findings are described with respect to (1) changes in behavior and emotions between baseline and follow‐up, (2) factors associated with changes in behavior and emotions, and (3) impact of study quality on findings. Results Fifteen studies met inclusion criteria. The majority of studies employed parent report screening checklists. In these studies, scores were reported to have significantly improved at follow‐up on at least one domain in seven studies and not to have changed significantly in two studies. In no studies was a deterioration in behavior noted. In studies that used Diagnostic and Statistical Manual of Mental Disorders (DSM) clinical diagnoses, no significant change was noted in the numbers of children diagnosed at baseline and at follow‐up. In total, 21 children lost diagnoses, whereas 16 children developed new diagnoses. A better seizure outcome was associated with improvements in behavioral‐emotional functioning at follow‐up in three of the four studies where it was considered. In terms of study quality, none of the studies was rated as strong (ie, had no weak ratings on a quality assessment tool). Significance There is some evidence of improvement in emotional and behavioral functioning after epilepsy surgery. However, this is confined to scores on parent‐reported screening measures of emotional and behavioral symptoms and not clinical diagnoses. Future research should focus on including responses from multiple respondents (child, parent, teacher) when using screening instruments, but also diagnostic interviews. There is a need for long‐term follow‐up (beyond 2 years) with sufficiently large sample sizes including data from nonsurgery controls to understand factors associated with changes in functioning postsurgery.

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“…In children the rate of self-reported anxiety is higher than parent-reported showing the importance of relying on the children's self-assessment wherever possible (Reilly et al, 2015). Persons in the general population (not restricted to persons with epilepsy) with a diagnosis of anxiety disorder at age 26 have had an anxiety disorder during adolescence in many cases (KimCohen et al, 2003).…”

Section: Anxiety In Childhood and Adolescencementioning

confidence: 99%

Anxiety disorders in people with epilepsy

Brandt¹,

Mula

2016

Epilepsy & Behavior

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Anxiety disorders are frequent, though probably underdiagnosed comorbidities in epilepsy.Epilepsy and anxiety may share common neurobiological correlates as shown in animal models and suggested by studies demonstrating anxiety disorders before the manifestation of epilepsy. Comorbid anxiety disorders have a major impact on the affected patients' qualityof-life and may increase the risk for suicidality. Successful treatment of the epilepsy may alleviate anxiety symptoms. Treatment of anxiety is based on selective serotonin reuptake inhibitors, benzodiazepines (although only further choice) and psychotherapy. Specific AEDs (especially pregabalin) have been shown to have anxiolytic properties. This paper is aimed at reviewing anxiety disorders in patients with epilepsy discussing current scientific evidence about pathophysiology, clinical aspects and treatment strategies.

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Symptoms of anxiety and depression in school-aged children with active epilepsy: A population-based study

Abstract: Symptoms of anxiety were more common based on self-report compared with parent-report. Children with generalized seizures reported more symptoms of depression and anxiety.

Cited by 27 publications

References 40 publications

Longitudinal trajectories of depression symptoms in children with epilepsy

Longitudinal trajectories of depression symptoms in children with epilepsy

Do behavior and emotions improve after pediatric epilepsy surgery? A systematic review

Anxiety disorders in people with epilepsy

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