title: Screening for mental health disorders in active childhood epilepsy: population-based data.
abstract: BACKGROUND
  Children with epilepsy are at increased risk for behavioral and psychiatric disorders and it has been recommended that all children with epilepsy be screened for such conditions. There is thus a need to identify appropriate screening measures in this population.
  
  
  METHODS
  Children with active epilepsy (on AEDs and/or had a seizure in the last year) with an IQ>34 (n=69) were screened for behavioral/psychiatric disorders using the parent and teacher versions of the Strengths and Difficulties Questionnaire (SDQ) in a population-based sample. Consensus clinical diagnoses were made with respect to DSM-IV-TR data. Parent and teacher responses on the SDQ total and subscales were compared using paired samples t-tests and Pearson's correlation. The screening properties of the SDQ were explored. Regression using generalized estimating equations was used to identify predictors of responses on the SDQ.
  
  
  RESULTS
  62% of children received a DSM-IV-TR diagnosis. On the total SDQ score the number of children identified at risk by parents (61%) was higher than the number identified by teachers (43%). Mean parent scores were significantly higher than teacher scores on the SDQ Conduct and Hyperactive subscales and total score after Bonferroni correction (adjusted alpha p<.007). Sensitivity and specificity of the SDQ total score were maximized by combining parent and teacher responses. The positive predictive values (PPVs) were much higher for the total score than the specific subscales suggesting that while the SDQ total score has good predictive ability the specific scales are less useful. Respondent (i.e., parent and teacher) was a significant predictor of scores for some but not all subscales.
  
  
  CONCLUSIONS
  The SDQ can be considered a promising tool for screening children with active epilepsy provided the total score is used as a screener for the presence of any DSM-IV-TR disorder and multi-informant data are used.
authors.affiliation: Research Department, Young Epilepsy, Lingfield, Surrey RH7 6PW, UK; Gillberg Neuropsychiatry Centre, University of Gothenburg, Kungsgatan 12, Gothenburg, Sweden. Electronic address: creilly@youngepilepsy.org.uk.
authors.forename: Colin
authors.initials: C
authors.lastname: Reilly
authors.affiliation: Child Development Centre, Crawley Hospital, West Green Drive, Crawley RH11 7DH, West Sussex, UK.
authors.forename: Patricia
authors.initials: P
authors.lastname: Atkinson
authors.affiliation: Research Department, Young Epilepsy, Lingfield, Surrey RH7 6PW, UK; Neurosciences Unit, Institute of Child Health, University College London, 4/5 Long Yard, London WC1N 3LU, UK; Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, London WC1N 3JH, UK.
authors.forename: Krishna B
authors.initials: KB
authors.lastname: Das
authors.affiliation: Muir Maxwell Epilepsy Centre, Edinburgh Neurosciences, The University of Edinburgh, Edinburgh, UK.
authors.forename: Richard F
authors.initials: RF
authors.lastname: Chin
authors.affiliation: Neurosciences Unit, Institute of Child Health, University College London, 4/5 Long Yard, London WC1N 3LU, UK; Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, London WC1N 3JH, UK.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Aylett
authors.affiliation: Research Department, Young Epilepsy, Lingfield, Surrey RH7 6PW, UK.
authors.forename: Victoria
authors.initials: V
authors.lastname: Burch
authors.affiliation: Gillberg Neuropsychiatry Centre, University of Gothenburg, Kungsgatan 12, Gothenburg, Sweden; Neurosciences Unit, Institute of Child Health, University College London, 4/5 Long Yard, London WC1N 3LU, UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: Gillberg
authors.affiliation: College of Medicine, University of Vermont, Burlington, VT 05405, USA; Neurosciences Unit, Institute of Child Health, University College London, 4/5 Long Yard, London WC1N 3LU, UK; Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, London WC1N 3JH, UK.
authors.forename: Rod C
authors.initials: RC
authors.lastname: Scott
authors.affiliation: Research Department, Young Epilepsy, Lingfield, Surrey RH7 6PW, UK; Neurosciences Unit, Institute of Child Health, University College London, 4/5 Long Yard, London WC1N 3LU, UK.
authors.forename: Brian G R
authors.initials: BG
authors.lastname: Neville
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000150:complications*; D005178:Faculty; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications* / Q000175:diagnosis*; D010290:Parents; D011569:Psychiatric Status Rating Scales; D012372:ROC Curve; D012044:Regression Analysis; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires
keywords: Behavior; Psychiatric; Screening