Depression and anxiety in childhood epilepsy: a review

Population based studies suggest that symptoms of depression and anxiety are more frequent in children and adolescents with epilepsy compared with the general population. In terms of the manifestations of symptoms of depression and anxiety, there would appear to some symptoms unique to epilepsy in that they are associated with seizures and/or antiepileptic medications but these idiosyncratic symptoms remain under reported and have not been extensively studied. In terms of correlates of significant symptoms of depression and anxiety in children with epilepsy, some reports indicate that seizure variables (e.g., seizure frequency) and use of polytherapy are associated with increases in symptoms whereas other studies have not found this relationship. Child and family attitude/adaptation to epilepsy may also be risk factors for depression and anxiety but more research is needed in this area. The assessment of symptoms of depression and anxiety in children with epilepsy can be challenging given the possible role of seizures and AEDs, and comprehensive assessment will involve the use of screening measures, diagnostic interviews and a consideration of epilepsy specific factors. There have been few studies carried out with respect to the treatment of symptoms and depression and anxiety in children and adolescents with epilepsy. There is a significant need for a greater understanding of the nature of symptoms of depression and anxiety in children with epilepsy to inform treatment decisions. While treatment of epilepsy specific symptoms of depression and anxiety may involve an evaluation of the current epilepsy treatment protocols, there may also be a need for pharmacological and/or psychotherapeutic interventions in the treatment of symptoms of depression and anxiety which are not epilepsy specific.