Psychosocial difficulties in children of parents with epilepsy: A pilot case-control study

Epilepsy is a chronic neurological disorder that may affect family functioning. Although the psychosocial impact on children of parents with several chronic medical and neurological disorders has been studied, a notable gap remains regarding epilepsy. This pilot study aimed to examine psychosocial outcomes in children aged 6-17 years whose parents have epilepsy and to explore emotional and behavioral difficulties within a multifactorial framework.

This observational pilot case-control study was conducted between 2023 and 2025 at neurology departments in Giresun and Erzurum. The epilepsy group (n = 45) was compared with a control group (n = 48) recruited from the same hospitals for non neurological reasons. Assessments included the Conners Parent Rating Scale (CPRS), Strengths and Difficulties Questionnaire (SDQ), and Perceived Stress Scale (PSS), analyzed as continuous measures. Small sample size and risk of model overfitting precluded multivariable covariate adjustment; the Benjamini-Hochberg False Discovery Rate procedure was applied to account for multiple testing.

Children of parents with epilepsy had higher rates of chronic medical conditions and ADHD diagnoses than controls. They also had higher SDQ emotional symptoms and hyperactivity/inattention scores, as well as higher CPRS total and problem related subscale scores. No significant between group differences were observed in total SDQ or PSS scores. In exploratory analyses by parental gender, children of fathers with epilepsy had higher SDQ total, emotional, and hyperactivity/inattention scores, as well as higher CPRS total and executive functioning scores. Fathers with epilepsy also reported higher PSS scores than mothers with epilepsy. Longer breastfeeding duration was inversely associated with CPRS total, hyperactivity/impulsivity, conduct, and peer relationship scores.

Children of parents with epilepsy showed differences in selected emotional and behavioral domains rather than global psychosocial impairment. Exploratory findings related to parental gender and breastfeeding duration should be interpreted cautiously. The small, non probability sample, baseline group differences, inability to control for key epilepsy specific clinical characteristics because of sample size constraints, limited assessment of epilepsy related factors, and potential residual confounding limit causal interpretation and generalizability. These preliminary, hypothesis generating findings warrant confirmation in larger longitudinal studies incorporating multiple informants and family related factors.