Psychiatric disorders and behavioral characteristics of pediatric patients with both epilepsy and attention-deficit
Joseph Gonzalez-Heydrich1, Alice Dodds, Jane Whitney
1Psychopharmacology Program, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115, USA. joseph.gonzalez-heydrich@tch.harvard.edu
Insights
Children with epilepsy and ADHD show similar psychiatric comorbidities to those with ADHD alone. This suggests shared underlying causes for attention-deficit hyperactivity disorder in both groups.
Area of Science:
- Child Neurology
- Neurodevelopmental Disorders
- Pediatric Psychiatry
Background:
- Attention-deficit hyperactivity disorder (ADHD) co-occurring with epilepsy is not well-characterized.
- Understanding this comorbidity is crucial for effective treatment strategies in children.
Purpose of the Study:
- To compare clinical features and psychiatric comorbidities in children with both epilepsy and ADHD.
- To contrast these findings with existing literature on children with ADHD but without epilepsy.
Main Methods:
- Utilized the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children (KSADS).
- Assessed cognitive abilities using the Wechsler Abbreviated Scale of Intelligence (WASI).
- Evaluated adaptive functioning with the Scales for Independent Behavior-Revised (SIB-R).
Main Results:
- The mean Intelligence Quotient (IQ) was 86 (±19), with a mean SIB-R Standard Score of 72 (±26).
- ADHD-Combined subtype (inattentive and hyperactive symptoms) was most prevalent (58%).
- Comorbid disorders were present in 61% of participants, including anxiety disorders (36%) and oppositional defiant disorder (31%).
Conclusions:
- The pattern of psychiatric comorbidity in children with ADHD and epilepsy mirrors that found in children with ADHD without epilepsy.
- Preliminary findings suggest common pathophysiological mechanisms underlying ADHD in both epilepsy and non-epilepsy populations.
Objective:
Attention-deficit hyperactivity disorder (ADHD) coexisting with epilepsy is poorly understood; thus, we compared the clinical correlates and psychiatric comorbid conditions of 36 children with epilepsy and ADHD aged 6 to 17 years enrolled in an ADHD treatment trial, with those reported in the literature on children with ADHD without epilepsy.
Methods:
Measures included the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children (KSADS), the Wechsler Abbreviated Scale of Intelligence (WASI), and the Scales for Independent Behavior-Revised (SIB-R).
Results:
Mean IQ was 86+/-19, and SIB-R Standard Score was 72+/-26. The ADHD-Combined subtype, composed of both inattentive and hyperactive symptoms, was most frequent (58%). Sixty-one percent exhibited a comorbid disorder, including anxiety disorders (36%) and oppositional defiant disorder (31%).
Conclusions:
Comorbidity in ADHD with epilepsy is similar to that in ADHD without epilepsy reported in the literature. These preliminary data argue that the pathophysiology of ADHD has common components in both populations.
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