Conference Coverage

Psychopathology management skills in childhood epilepsy vary across settings


 

AT THE ANNUAL MEETING OF THE AMERICAN EPILEPSY SOCIETY

SAN DIEGO – Behavioral health professionals who work in a school or hospital had better attitudes and felt more comfortable managing psychopathology in children with epilepsy, compared with their counterparts who provided treatment in the community.

However, no statistically significant differences were observed in the attitude, knowledge, or comfort in managing psychopathology among providers in the various disciplines who care for this patient population. The findings come from an online survey of 146 psychologists, clinical counselors, clinical social workers, physicians, and other health care professionals.

Jayne Pacheco-Phillips

"For the past several years there have been many articles coming out regarding the comorbidities in epilepsy, [including] depression, anxiety, cognitive difficulties, issues with memory and learning," Jayne Pacheco-Phillips said during a press briefing at annual meeting of the American Epilepsy Society. "Everyone has started to talk about referring these children early for services. However, no one has looked at what the people who are providing the services know or believe about epilepsy."

Ms. Pacheco-Phillips, a licensed independent social worker in the division of child neurology at Nationwide Children’s Hospital, Columbus, Ohio, and her associates sent a link to an online questionnaire to the clinical directors of nine government-funded agencies that primarily provide services to children and youth in Franklin County, Ohio. Clinical directors then distributed the link to an estimated 500 behavioral health care professionals. The survey included 21 questions based on a Likert scale and was intended to assess the knowledge, attitudes, and the comfort of behavioral health professionals in terms of managing psychopathology in children with epilepsy.

Ms. Pacheco-Phillips reported findings from 146 providers who completed the entire survey, including psychologists, clinical counselors, clinical social workers, physicians, nurses, and those in unlicensed/other roles. Of the 146 respondents, 70 said that they did not know someone with epilepsy while the remaining 76 said they did.

Respondents who provided services in an institution, such as a school or hospital, possessed better attitudes (P = .003) and more comfort in managing psychopathology in children with epilepsy (P = .002), compared with those who provided treatment in the community, such as in families’ homes or in mental health agencies. Respondents who reported having witnessed a seizure had a higher comfort level in managing psychopathology in children (P = .001). Similarly, those who know someone with epilepsy indicated a better attitude (P = .003) and are more comfortable managing psychopathology (P = .007).

"Within the disciplines, we did not find a statistically significant difference in attitudes," Ms. Pacheco-Phillips added. "We were surprised by this. The physicians [surveyed] included psychiatrists and developmental pediatricians. Another interesting point was that 84% of the providers overall indicated that they would be interested in receiving additional education about psychopathology in epilepsy."

One of her coauthors, Dr. Lorie D. Hamiwka, characterized the study findings as important for all epilepsy providers, "because when families come to the clinic, a lot of these comorbidities that we see are more debilitating for children and families than the seizures are themselves," said Dr. Hamiwka, a neurologist at Nationwide Children’s. "They’re often a bigger burden."

Ms. Pacheco-Phillips said that she had no relevant financial conflicts to disclose.

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