Self-esteem and symptoms of depression in children with seizures: relationships with neuropsychological functioning and family variables over time.
OBJECTIVE
To test over time the relationships of neuropsychological functioning to mental health in children following a first recognized seizure and, of primary importance, to determine if the strength of these relationships differs based on risk and protective factors.


METHODS
In a larger prospective study, 135 children with a first seizure (ages 8-14 years) and 73 healthy sibling controls completed neuropsychological testing at baseline and 36 months. Structured telephone interviews were used to obtain data from children on mental health and family environment; major caregiving parents provided data on demographic and family variables. Data analyses included correlation coefficients and linear regression models.


RESULTS
Children with seizures showed an overall trend for improvement in mental health. More children with seizures than siblings had declines in processing speed. Declines in neuropsychological functioning were correlated with worse mental health. With regard to risk and protective factors, higher parent education protected against decline in self-esteem related to decline in processing speed. Better family functioning and greater parental support protected against decline in self-esteem related to decrease in verbal memory and learning. Older child age protected against increase in depressive symptoms related to decline in processing speed.


CONCLUSIONS
Seizure onset had a negative impact on mental health in children with declines in cognitive functioning except for older children and those with more family resources. Children should be assessed for declines in processing speed and, if found, those subgroups of children with less educated or more anxious parents and those in less supportive families should be targeted for interventions.
Austin
Joan K
JK
Department of Environments for Health, Indiana University School of Nursing, Indianapolis, Indiana 46202-5107, USA. joausti@iupui.edu
Perkins
Susan M
SM
Johnson
Cynthia S
CS
Fastenau
Philip S
PS
Byars
Anna W
AW
deGrauw
Ton J
TJ
Dunn
David W
DW
D000293:Adolescent; D000367:Age Factors; D017668:Age of Onset; D002648:Child; D003863:Depression / Q000175:diagnosis* / Q000523:psychology; D005163:Factor Analysis, Statistical; D005190:Family; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D010290:Parents / Q000523:psychology; D011446:Prospective Studies; D012044:Regression Analysis; D012640:Seizures / Q000175:diagnosis* / Q000523:psychology; D012649:Self Concept