Beyond Seizures: Psychiatric comorbidities in children with epilepsy

Area of Science:

• Pediatric Neurology
• Child Psychiatry
• Epidemiology

Background:

• Children with epilepsy face a higher risk of psychiatric comorbidities, which can worsen their condition.
• These comorbidities are often underdiagnosed and underreported in developing nations.

Purpose of the Study:

• To determine the frequency of psychiatric disorders in a large cohort of children with epilepsy in Lebanon.
• To identify factors associated with psychiatric comorbidities in this population.

Main Methods:

• Prospective cohort study of 598 children with new-onset seizures in Lebanon (2010-2016).
• Analysis of medical records for psychiatric disorders (internalizing/externalizing) based on DSM-5 criteria.
• Multivariable logistic regression used to identify associated factors.

Main Results:

• 12.5% of children (75/598) were diagnosed with psychiatric disorders: 5.0% internalizing and 7.9% externalizing.
• Externalizing disorders were most frequent in developmental epileptic encephalopathies (18.2%); intellectual/developmental delay was a key factor (OR 3.36).
• Internalizing disorders were associated with failure of ≥2 antiseizure medications (OR 3.25) and older age at seizure onset (OR 6.86).

Conclusions:

• The diagnosed prevalence of psychiatric comorbidities was lower than in developed countries, suggesting potential underreporting in Lebanon.
• Systematic psychiatric screening is crucial during routine visits, especially for children with developmental delays or poor seizure control.