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Febrile seizures and childhood epilepsy and risk of internalizing and psychotic symptoms

Sofie J Nielsen1, Bodil H Bech1, Katrine Strandberg-Larsen2

  • 1Department of Public Health, Aarhus University, Aarhus, Denmark.

Epilepsia
|August 31, 2024
PubMed

Insights

Children with epilepsy show a higher risk of internalizing symptoms by age 11. Febrile seizures in childhood did not increase the risk for psychiatric symptoms or psychotic-like experiences.

Area of Science:

  • Child neurology
  • Developmental psychology
  • Psychiatry

Background:

  • Childhood seizures, including febrile seizures and epilepsy, are common neurological conditions.
  • Internalizing symptoms and psychotic-like experiences are significant child psychiatric concerns.
  • Understanding the long-term mental health risks associated with childhood seizures is crucial for early intervention.

Purpose of the Study:

  • To investigate the association between childhood febrile seizures and/or epilepsy and the risk of internalizing symptoms or psychotic-like experiences at age 11.
  • To identify specific risk factors within the epilepsy group that may predict psychiatric symptom development.

Main Methods:

  • A large cohort study of 44,819 children from the Danish National Birth Cohort was conducted.
  • Childhood seizure data were obtained from the Danish National Patient Registry.
  • Child psychiatric symptoms were assessed at age 11 using validated questionnaires, including the Adolescent Psychotic-like Symptom Screener and the Strength and Difficulties Questionnaire.

Main Results:

  • No significant association was found between febrile seizures and psychiatric symptoms, nor between epilepsy and psychotic-like experiences.
  • Children with epilepsy had a significantly higher odds ratio (OR) of 1.76 for internalizing symptoms compared to controls.
  • This increased risk for internalizing symptoms in epilepsy was particularly pronounced in boys (OR 2.30) and those with more severe epilepsy (≥2 hospital admissions or onset at 0-3 years).

Conclusions:

  • Febrile seizures in childhood are not associated with an increased risk of psychiatric symptoms or psychotic-like experiences at age 11.
  • Epilepsy in childhood is linked to a higher risk of internalizing symptoms, especially in boys and those with more severe disease.
  • Further research is warranted to understand the underlying mechanisms and develop targeted support for children with epilepsy experiencing internalizing symptoms.
Abstract

Keywords:
childhood seizuresepidemiologyneurodevelopmental disordersstatisticsthe Danish National Birth Cohort

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