title: Adjustment in children with intractable epilepsy: importance of seizure duration and family factors.
abstract: Seventy-five families of children with intractable epilepsy but without a severe learning disability (mean age 7 years 1 month, SD 2 years 6 months; range 2 to 12 years) who attended a regional paediatric neurology service, were surveyed. A postal questionnaire was used which included standardized measures of child and family adjustment; forty-eight families responded (64%; 31 males, 17 females). There was no significant difference between responders and non-responders in terms of age, sex, number of other chronic illnesses and disabilities, age at epilepsy diagnosis, seizure type, nor number of antiepileptic drugs currently prescribed (p > 0.05). The importance of including multidimensional measures of outcome was highlighted by the finding that epilepsy, pharmacological, and psychosocial factors were differentially associated with specific adjustment difficulties. Two factors appeared to be most pervasively implicated across a range of adjustment problems: frequency of rectal diazepam administration and family patterns of relating to each other (p < 0.05). It appeared that duration of seizures (as indicated by frequency of rectal diazepam administration), rather than the frequency of seizures per se, was more pernicious in terms of poor adjustment. Intrafamilial relations (degree of conflict/cohesion and soon) were not only associated with adjustment difficulties in the child, but also with the frequency of seizures themselves. Implications for psychological interventions in intractable epilepsy in childhood are highlighted.
authors.affiliation: Department of Clinical Psychology, The Royal Belfast Hospital for Sick Children, Northern Ireland. chris.mccusker@royalhospitals.n-i.nhs.uk
authors.forename: Christopher G
authors.initials: CG
authors.lastname: McCusker
authors.forename: Patrick John
authors.initials: PJ
authors.lastname: Kennedy
authors.forename: Jennifer
authors.initials: J
authors.lastname: Anderson
authors.forename: Elaine M
authors.initials: EM
authors.lastname: Hicks
authors.forename: Donncha
authors.initials: D
authors.lastname: Hanrahan
mesh_terms: D000223:Adaptation, Psychological; D000285:Administration, Rectal; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000523:psychology; D002675:Child, Preschool; D003975:Diazepam / Q000008:administration & dosage / Q000009:adverse effects; D004828:Epilepsies, Partial / Q000188:drug therapy / Q000523:psychology*; D005195:Family Relations; D005260:Female; D006801:Humans; D008297:Male; D009460:Neurologic Examination; D010552:Personality Assessment; D012803:Sick Role; D012917:Social Adjustment
chemical_list: D000927:Anticonvulsants; D003975:Diazepam