[Emotional and behavioral comorbidities and the impact on the quality of life in epilepsy children].
OBJECTIVE
To find out the rate of comorbidities of depression, anxiety disorder and attention deficit hyperactivity disorder (ADHD) symptoms in children with epilepsy and to analyze the relevant affecting factors and impacts on quality of life.


METHODS
Totally 142 children with various types of epilepsy underwent neuropsychological assessment with the Depression Self-rating Scale for Children, the Screen for Child Anxiety Related Emotional Disorders and the ADHD Rating Scale-IV, an 18-item parent-rated questionnaire based on the diagnostic criteria for ADHD, the quality of life was measured in 100 cases on antiepileptic medications by the Quality of Life in Epilepsy Inventory (QOLIE-31). The comorbidity rates were calculated using t-test, chi(2) test and multiple logistic analysis, the variables associated with psychiatric comorbidities were determined, and the impact on quality of life was analyzed.


RESULTS
(1) The total rate of emotional and behavioral comorbidities was 57.7% (82/142), the frequency of depressive disorder, anxiety disorder and ADHD was 14.8%, 44.4% and 17.6%, respectively. The suicidal ideation occasionally occurred in 5.6% of the cases and 0.7% of cases often had the ideation, but no suicidal action was found in any case. (2) Risk factors for the emotional and behavioral disorders: multiple logistic analysis indicated that age, gender and epilepsy illness-related variables were not relative to the comorbidities, P > 0.05, there were interactions among the disorders. (3) The impact on the quality of life: The emotional and behavioral conditions were associated with the low quality of life, which was significantly lower in epileptic children with co-morbid disorder compared to non-comorbidities epilepsy group. Especially negative impact on the total score of quality of life and four sub-items such as overall quality, emotional well-being, cognitive and social function, P < 0.001. There were also significant differences between the two groups in the other three sub-items including fear for seizure attack, energy/fatigue and medication effects (P < 0.05).


CONCLUSIONS
The frequency of emotional and behavioral disorders including depress disorder, anxiety disorder and ADHD was considerably high in children with epilepsy. Age, gender and epilepsy illness-related variables are not associated with the emotional and behavioral comorbidities, which interfere with each other. Emotional and behavioral disorder is one of the negative factors to the quality of life in epileptic patients. Neuropsychological assessment and treatment are important for improvement of the quality of life in children with epilepsy.
Chen
Qian
Q
Department of Pediatric Neurology, Capital Institute of Pediatrics, Beijing 100020, China.
Yan
Xiu-xian
XX
Shang
Ning-xiu
NX
Zhang
Gui-zhen
GZ
Gao
Zhi-jie
ZJ
Wang
Yang
Y
Li
Er-zhen
EZ
Yang
Jian
J
Xu
Ke-ming
KM
D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology; D002648:Child; D002653:Child Behavior Disorders / Q000453:epidemiology / Q000473:pathology; D015897:Comorbidity; D004644:Emotions; D004827:Epilepsy / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D006801:Humans; D011788:Quality of Life; D011795:Surveys and Questionnaires