A population survey of mental health problems in children with epilepsy
Sharon Davies1, Isobel Heyman, Robert Goodman
1Great Ormond Street Hospital, London, UK.
Insights
Children with epilepsy have significantly higher rates of psychiatric disorders, emotional, behavioral, and relationship problems compared to children with diabetes or controls. These mental health challenges represent a substantial burden, necessitating targeted support services.
Area of Science:
- Child and Adolescent Psychiatry
- Epidemiology
- Developmental Psychology
Background:
- Children with epilepsy face unique challenges impacting their mental health.
- Previous research has not fully quantified the extent of emotional, behavioral, and relationship problems in this population.
- This study addresses a gap in understanding the mental health burden on children with epilepsy and their families.
Purpose of the Study:
- To investigate the prevalence of psychiatric disorders in children with epilepsy.
- To compare the mental health outcomes of children with epilepsy to those with diabetes and healthy controls.
- To identify specific emotional, behavioral, and relationship difficulties associated with childhood epilepsy.
Main Methods:
- Utilized data from the 1999 British Child and Adolescent Mental Health Survey, a nationwide epidemiological study.
- Interviewed main carers and teachers for 10,316 children, identifying 67 with epilepsy, 47 with diabetes, and 10,202 controls.
- Employed DSM-IV criteria via the Development and Well-Being Assessment, specialist clinician ratings, and parental reports to assess psychiatric diagnoses and behavioral problems.
Main Results:
- Children with epilepsy exhibited significantly higher rates of psychiatric disorder (37%) compared to children with diabetes (11%) and controls (9%).
- Parents of children with epilepsy reported more emotional, behavioral, and peer problems, with a greater impact.
- Epilepsy, independent of age, sex, and learning difficulties, was strongly associated with all behavioral variables, unlike diabetes.
Conclusions:
- Emotional, behavioral, and relationship difficulties are prevalent and burdensome for children with epilepsy and their families.
- The findings underscore the critical need for accessible and effective mental health services tailored to children with epilepsy.
- Epilepsy is an independent risk factor for significant mental health impairments in childhood.
Abstract:
The 1999 British Child and Adolescent Mental Health Survey, a nationwide epidemiological study of rates of psychiatric disorder in children aged 5 to 15 years, provided the opportunity to investigate the mental health of children with epilepsy. These children and their families experience disability specifically because of additional emotional, behavioural, and relationship problems, and this is the first epidemiological study that directly measures these impairments. Information was obtained by interviewing a main carer and teacher for 10,316 children; 67 children with epilepsy were identified (35 males, 32 females; mean age 10 years 2 months, SD 2 years 11 months, range 5 to 15 years), and compared with the 47 children with diabetes (27 females, 20 males; mean age 10 years 4 months, SD 3 years 4 months, range 5 to 15 years) and 10,202 controls (50% male; mean age 9 years 11 months, SD 3 years 1 month, range 5 to 15 years). DSM-IV psychiatric diagnoses were derived from the Development and Well-Being Assessment in combination with the interview and a specialist clinician rating. Parental reports of emotional and behavioural problems, their impact, and associated peer problems were also obtained. Rates of psychiatric disorder were 37% (95% confidence interval [CI] 22 to 49) in epilepsy, 11% (95% CI 2 to 19%) in diabetes, and 9% (95% CI 9 to 10%) in control children. Parents of children with epilepsy consistently reported more problems, with greater impact and associated peer problems. Epilepsy, but not diabetes, was independently (adjusted for age, sex, and severe learning difficulties) associated with all behavioural variables in regression analyses. Emotional, behavioural, and relationship difficulties are common in children with epilepsy, and constitute a significant burden to the children and their families, indicating the need for effective mental health services for these children.
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