Anxiety and depressive symptoms in children presenting with a first seizure

We investigated whether children presenting with a first seizure experienced anxiety and depressive signs. Children (aged 7-17 years) with a first unprovoked afebrile seizure participated. These patients (mean age, 12 +/- 2.7 years S.D.; 14 female/8 male) completed the Revised Child Manifest Anxiety Scale (n = 22) and Children's Depression Inventory (n = 20). Scores were compared with: (1) published norms, and (2) control patients with new medical signs. Compared with the published norms, children reported greater total anxiety (P < 0.02), worry/oversensitivity (P < 0.008), and social concerns/concentration (P < 0.005). However, compared with the control patients, no difference was seen between groups. Total Children's Depression Inventory scores were higher than for published norms (P = 0.05) and control patients (P = 0.04). Children with a first seizure reported greater interpersonal problems (P < 0.01), ineffectiveness (P < 0.03), and negative self-esteem (P < 0.05) than published norms, and increased negative mood (P = 0.04), ineffectiveness (P = 0.04), anhedonia (P = 0.05), and negative self-esteem (P = 0.05) than control patients. Our results suggest that anxiety may be related to an illness or to the hospital experience itself, whereas depressive signs may be a comorbidity present at time of presentation of the first seizure. If a larger cohort substantiates these results, early screening for these signs would be of clinical importance.