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10-year research update review: psychiatric problems in children with epilepsy

Sigita Plioplys¹, David W Dunn, Rochelle Caplan

¹Department of Child and Adolescent Psychiatry, Children's Memorial Hospital, Chicago, IL 60614, USA. splioply@childrensmemorial.org

Journal of the American Academy of Child and Adolescent Psychiatry

|December 1, 2007

Insights

Psychopathology is common in children with epilepsy (CWE), affecting 37-77%. Early identification and integrated treatment are crucial for managing these neuropsychiatric conditions in pediatric epilepsy.

Area of Science:

Neuropsychiatry
Pediatric Neurology
Child Psychology

Background:

Epilepsy is increasingly recognized as a complex neuropsychiatric disorder.
Children with epilepsy (CWE) exhibit a high prevalence of psychopathology.
Understanding psychopathology in CWE is vital for comprehensive care.

Purpose of the Study:

To conduct a critical literature review on psychopathology in children with epilepsy (CWE).
To synthesize findings on epidemiology, risk factors, clinical characteristics, treatment, and outcomes.
To inform clinical practice for mental health professionals.

Main Methods:

Systematic literature search of Medline and PsychInfo databases (1996-2007).
Inclusion of original studies on psychopathology in individuals aged 0-18 years.
Selective presentation of clinically relevant findings.

Main Results:

Psychopathology affects 37% to 77% of CWE, with potential epilepsy-specific issues like attention and thought problems.
Cognitive, linguistic deficits, and family factors influence psychopathology.
Children with severe epilepsy syndromes show high rates of developmental delay and autistic symptoms.

Conclusions:

Epilepsy is a neuropsychiatric disorder encompassing seizures, psychopathology, and cognitive/linguistic issues.
Early identification of at-risk CWE is essential.
Multidisciplinary management and evidence-based psychiatric treatment are recommended.

Read full analysis

Abstract

Objective:

To critically review literature published from 1996 to 2007 on psychopathology in children with epilepsy (CWE).

Method:

Using Ovid, we searched Medline and PsychInfo databases for original studies on epidemiology, risk factors, clinical characteristics, treatment, and outcome of psychopathology in CWE, ages 0 to 18 years, using the terms "psychopathology," "emotional and behavioral problems," and "mental health problems." We selectively present the findings of studies that are clinically relevant to mental health professionals.

Results:

Psychopathology occurs in 37% to 77% of CWE, and attention, internalizing, and thought problems may be specific to epilepsy. Cognitive and linguistic deficits, as well as family factors, have moderating effects on psychopathology in CWE. The association of epilepsy-related variables, including antiepileptic drugs, with psychopathology is inconsistent in cognitively normal CWE. Children with symptomatic epilepsy and devastating epilepsy syndromes have high rates of global developmental delay, hyperactivity, and autistic symptoms. The treatment of psychopathology in CWE integrates standard psychiatric practices.

Conclusions:

Epilepsy is a neuropsychiatric disorder characterized by seizures, psychopathology, cognitive, and linguistic problems. Improved early identification of CWE at risk for psychopathology, evidence-based psychiatric treatment, and multidisciplinary management strategies would advance clinical practice in this highly complex field of pediatric neuropsychiatry.

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