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Risk Factors for Psychiatric Disorders in Pediatric Patients with Tuberous Sclerosis Complex

Jianqing Cao1, Meilin Liu2, Tianyan Zhang3

  • 1Department of Neurology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.

Neuropediatrics
|March 5, 2025
PubMed

Insights

Psychiatric disorders are common in children with tuberous sclerosis complex (TSC). Seizure frequency, medication use, and intellectual disability are key risk factors for autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD) in these children.

Area of Science:

  • Pediatric Neurology
  • Child Psychiatry
  • Genetics

Background:

  • Tuberous sclerosis complex (TSC) is a genetic disorder that can lead to various neurological and developmental issues.
  • Psychiatric comorbidities are frequently observed in children with TSC, impacting their quality of life and management.
  • Identifying specific risk factors is crucial for early diagnosis and intervention.

Purpose of the Study:

  • To identify and evaluate risk factors for psychiatric disorders in pediatric patients diagnosed with tuberous sclerosis complex (TSC).
  • To analyze the prevalence of autism spectrum disorder (ASD), attention-deficit hyperactivity disorder (ADHD), anxiety, and depression in children with TSC.

Main Methods:

  • A cohort of 121 children with TSC was recruited from Hangzhou Children's Hospital.
  • Psychiatric comorbidities were screened and diagnosed using the autism behavior checklist, SNAP-IV scale, and self-rating anxiety and depression scales.
  • Univariate and multivariate logistic regression analyses were employed to determine risk factors.

Main Results:

  • Over half (57.85%) of the children with TSC presented with comorbid psychiatric disorders.
  • Autism spectrum disorder (ASD) was diagnosed in 42.15%, ADHD in 40.50%, anxiety in 14.05%, and depression in 11.57%.
  • Key risk factors for ASD included frequent seizures, multiple anti-seizure medications, infantile spasms, ADHD, and intellectual disability. ASD was a risk factor for ADHD. Seizure characteristics were linked to anxiety and/or depression.

Conclusions:

  • Psychiatric comorbidities are highly prevalent in pediatric patients with TSC.
  • Specific clinical factors, including seizure characteristics and co-occurring conditions like intellectual disability, significantly increase the risk for psychiatric disorders.
  • These findings offer valuable insights for the diagnosis and treatment strategies for psychiatric comorbidities in children with TSC.

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