Behavioral disorders in pediatric epilepsy: unmet psychiatric need.
OBJECTIVE
This study examined the relation between psychiatric diagnosis and mental health services in children with epilepsy and the associated demographic, cognitive, linguistic, behavioral, and seizure-related variables.


METHODS
The Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS), the Child Behavior Checklist, the Test of Language Development, and the Wechsler Intelligence Scale for Children-Revised (WISC-R) were administered to 114 children, aged 5 to 16 years, with either complex partial seizures (CPS) or primary generalized with absence (PGE, petit mal). A Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) diagnosis and information regarding mental health services were derived from the K-SADS.


RESULTS
Although approximately 60% of the subjects had a DSM-IV psychiatric diagnosis, >60% received no mental health treatment. Absence of mental health care was associated with younger age, less parental education, limited number of antiepileptic drugs (AEDs; i.e., one or none), and higher verbal IQ. In addition, children with PGE and a single psychiatric diagnosis were less likely to have a history of mental health treatment.


CONCLUSIONS
This is the first study to demonstrate unmet mental health need in a large sample of children with CPS and PGE. The study's findings suggest that parents and clinicians should be aware of the mental health needs of children with epilepsy, particularly if they have one or more of the identified risk factors.
Ott
Derek
D
Department of Psychiatry, University of California at Los Angeles, Los Angeles, California, USA. dott@mednet.ucla.edu
Siddarth
Prabha
P
Gurbani
Suresh
S
Koh
Susan
S
Tournay
Anne
A
Shields
W Donald
WD
Caplan
Rochelle
R
D000293:Adolescent; D002140:California / Q000453:epidemiology; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D002675:Child, Preschool; D015897:Comorbidity; D004569:Electroencephalography; D004832:Epilepsy, Absence / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D017029:Epilepsy, Complex Partial / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D007360:Intelligence; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011594:Psychometrics; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors