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Socioeconomic deprivation is an independent risk factor for behavioral problems in children with epilepsy
Joanna Carson1, Andrew Weir1, Richard F Chin2
1The University of Edinburgh, UK.
Insights
Socioeconomic deprivation significantly increases behavioral problems in children with epilepsy (CWE). These children, particularly those in deprived areas, also receive less mental health support.
Area of Science:
- Pediatric Neurology
- Child Psychology
- Public Health
Background:
- Behavioral problems are common in children with epilepsy (CWE).
- Socioeconomic factors may influence health outcomes in children with epilepsy.
- The independent impact of socioeconomic deprivation on behavioral issues in CWE requires further investigation.
Purpose of the Study:
- To determine if socioeconomic deprivation is an independent risk factor for behavioral problems in children with epilepsy.
- To assess the association between socioeconomic status and the presence of significant behavioral issues in CWE.
- To explore disparities in mental health service access for CWE with behavioral problems based on socioeconomic status.
Main Methods:
- A cross-sectional study involving 87 children with epilepsy.
- Parental completion of the Child Behavior Checklist (CBCL) to assess behavioral problems.
- Utilized the Scottish Index of Multiple Deprivation (SIMD) based on postal codes to quantify socioeconomic deprivation.
- Regression analysis to identify independent risk factors for behavioral problems.
Main Results:
- Fifty-nine percent of children exhibited significant behavioral problems (CBCL score >63).
- Children from more deprived areas (SIMD quintiles 1-3) had higher rates of externalizing and total behavioral problems compared to those from less deprived areas (quintiles 4-5).
- Socioeconomic deprivation (quintiles 1-3) was a significant independent risk factor (Adjusted OR=14.8) for behavioral problems.
- Children with behavioral problems from deprived areas were less likely to be known to child and adolescent mental health services (CAMHS).
Conclusions:
- Socioeconomic deprivation is an independent risk factor for behavioral problems in children with epilepsy.
- Children with epilepsy and behavioral problems residing in socioeconomically deprived areas have reduced access to essential mental health support.
- Addressing socioeconomic disparities is crucial for improving behavioral health outcomes and service accessibility for children with epilepsy.
Aim:
The aim of this study was to examine whether socioeconomic deprivation in children with epilepsy (CWE) increases risk for behavioral problems independent of seizure factors.
Methods:
A cross-sectional study was done in which parents of children attending a specialist epilepsy clinic were invited to complete a child behavior checklist (CBCL) questionnaire about their child. Medical and sociodemographic data on CWE were obtained through their pediatric neurologists. Home postal code was used to obtain quintiles of Scottish Index of Multiple Deprivation 2012 (SIMD2012) scores for individuals. Lower (1-3) quintiles correspond to higher socioeconomic deprivation. Regression analysis was used to investigate whether a lower quintile was an independent risk factor for scores >63 (significant behavioral problem).
Results:
Parents of 87 children (42 male, mean age of 10.5years) were enrolled. Fifty-nine percent had total scores >63. A higher proportion of children from quintiles 1-3 compared to those from quintiles 4-5 had externalizing (49% vs. 25%, p=0.02) and total (54% vs. 30%, p=0.02) scores >63. Adjusted OR of quintiles 1-3 vs. 4-5 for scores >63=14.8, 95% CI=3.0, 68.0. Fewer children with scores >63 and from quintiles 1-3 were known to the child and adolescent mental health service (CAMHS) compared to those in quintiles 4-5 (p=0.01).
Interpretation:
Socioeconomic deprivation was an independent risk factor for behavioral problems in CWE. Children with epilepsy and behavioral problems who lived in socioeconomically deprived areas received less help.
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