Symptoms of Depression and Anxiety in Pediatric Epilepsy Patients

Abstract

Summary: Purpose:We assessed rates of symptoms of anxiety and depression among pediatric patients with epilepsy.Methods: We administered the Revised Child Manifest Anxiety Scale (RCMAS), and Child Depression Inventory (CDI) to 44 epilepsy patients aged 7-18 years (mean age 12.4 years). Demographic, socioeconomic, and epilepsy-related information was examined in relation to depression and anxiety scores.Results: No patients had been previously identified to have depression or anxiety. However, 26% had significantly increased depression scores and 16% met critieria for significant anxiety symptomatology. Conclusions: Symptoms of depression and anxiety are common among pediatric patients with epilepsy and appear to be overlooked by care providafs. Key Words: AnxietyDepression-Epilepsy-Seizures-Pediatric.Many controversial studies suggest that patients with epilepsy are at high risk for psychiatric disturbances (1-3) including depression (43) and anxiety (6-8). Most such studies are based on adults; there are far fewer studies of psychiatric symptoms in children and adolescents with seizures. Although depression in childhood has been reported to occur with administration of barbiturates (9), very little is known about overall rates and determinants of depression and anxiety in pediatric patients with epilepsy.Rutter et al. (10) reported psychiatric disturbances in as many as 33% of children with epilepsy but did not specifically delineate affective disorders. Hoare (1 1) noted higher rates of behavioral difficulties in children with epilepsy than in children with diabetes mellitus, but did not determine rates of anxiety and depression. The present study was therefore designed to (a) determine the degree to which the affective disorders (depression and anxiety) had been detected and treated in previous clinical care, (b) determine the frequency of depressive and anxiety-related symptoms among children and adolescents with epilepsy at present, and (c) examine the relationship between self-reported anxiety and depression symptoms with demographic and seizure-related factors. METHODSInclusion and exclusion criteria were as follows: Study entry was offered consecutively to outpatients (aged 7-18 years) with epilepsy (defined as recurrent unprovoked seizures) attending the Pediatric Neurology Department at the University at Stony Brook. Patients with mental retardation were excluded. Patients and their parents completed several self-report measures that examined the following variables:1. Demograptiic variables. Patient ages and sex were recorded. Ages were divided into groups aged 7-12 and 13-18 years. For each child, 1 parent completed the Hollingshead Index, a measure of socioeconomic status (SES) which contains questions about family income, marital and occupational status, and education (12). Scores from the Hollingshead Index were divided into scores of ~2 9 , 2 9 4 8 , and >48 to define lower, middle, and upper SES groups.

Amygdala volume and psychopathology in childhood complex partial seizures

“…There are high rates of comorbid MDD and anxiety disorders in adults (28)(29)(30)(31)(32)(33) and children with epilepsy (34)(35)(36)(37)(38)(39)(40)(41). Amygdala volume findings, however, vary with two studies showing increased volumes in presurgical TLE adults with depression (42,43) and two studies showing no change in volumes in individuals with TLE (44,45).…”

In adolescents with epilepsy, high scores of anxiety and depression are associated with occurrence of seizures in public places

“…Ettinger et al 5 applied the quantitative scales Revised Child Manifest Anxiety Scale (RCMAS) 6 and Child Depression Inventory (CDI) 7 to assess depression and anxiety in a population of 44 children and adolescents ( from 7 to 18 years) with epilepsy and found that 26% of patients had increased depression scores and 16% had anxiety symptomatology.…”

Psychiatric Disorders in Children and Adolescents with Epilepsy

“…[19,51,55,56] Epilepsi ile ilişkili faktörler arasında tanımlanan antiepileptik ilaç çoklu tedavisinim de anksiyete bozukluğu riski ile ilişkili bulunmuştur. [19,50,51,56] Ancak antiepileptik ilaç politerapisinin direk bir risk faktörü olup olmadığı kesin olarak aydınlanmamıştır. Monoterapiye yanıtsız olguların daha şiddetli epilepsi düzeyinde olması ve artan epilepsi şidde-tinin anksiyete bozukluğu riski ile ilişkili olduğu da düşünülebilir.…”