WASHINGTON – Comorbid psychiatric conditions appear to be very common among children with medically refractory epilepsy, Jay A. Salpekar, M.D., said at the annual meeting of the American Academy of Child and Adolescent Psychiatry.
In a study of 24 children (16 boys and 8 girls) recommended for epilepsy surgery, 22 were diagnosed with at least one psychiatric disorder, said Dr. Salpekar of Children's National Medical Center in Washington. Seven children were diagnosed with two or more psychiatric disorders
The patients ranged in age from 6 to 17 years and had an average IQ greater than 70. After undergoing clinical psychiatric evaluations, 12 children were diagnosed with anxiety disorders, 11 with attention deficit hyperactivity disorder, and 7 with mood disorders.
Parents completed the Child Behavior Checklist (CBCL) for their children, and 19 children had at least one CBCL subcategory T score above 65–1.5 standard deviations above normal. The most common problems were in the somatic, social, and attention subcategories. Thirteen children had at least one T score above 70–2 standard deviations above normal. The most common problems for these children were also in the somatic, social, and attention subcategories.
The 14 children with temporal lobe foci appeared to have more psychiatric problems than the 10 children with extratemporal foci. Among the children with temporal lobe foci, six were diagnosed with anxiety, eight with ADHD, and five with mood disorders. Each of these children averaged about two CBCL subcategory T scores greater than 65, and those with extratemporal lobe foci averaged one CBCL subcategory T score greater than 65, Dr. Salpekar reported.
Children with extratemporal lobe epilepsy also had fewer clinical psychiatric diagnoses. “There is something, not only about chronic epilepsy, but about temporal lobe chronic epilepsy” in particular, that leads to greater psychiatric comorbidity, he said.