title: Children's perspective of quality of life in epilepsy.
abstract: OBJECTIVE
  To study child mental health, parental support, and social support of children with epilepsy as these relate to quality of life (QOL) using child self-report, seizure-related variables, and estimated verbal intelligence based on receptive vocabulary.
  
  
  METHODS
  A cross-sectional structural equation model of baseline data from the QUALITÉ cohort study, which includes 6 Canadian child epilepsy ambulatory programs. A sample of 3,481 children were screened for the following eligibility: 8 to 14 years of age, with active or medication-managed epilepsy. Of 894 eligible children, 506 agreed to participate, of whom 26 were then excluded because of an inability to self-report based on a standard cutoff score of receptive vocabulary lower than 70. The primary outcome of child-reported QOL was measured using the Child Epilepsy QOL Questionnaire.
  
  
  RESULTS
  From the child's perspective, epilepsy-specific QOL is strongly related to their mental health and social support but not to their seizures. Specifically, child mental health and peer support exhibit direct associations with QOL; parental support has both direct and indirect associations with QOL (via child mental health); estimated verbal intelligence exerts its strongest association with QOL through mental health; and seizure status exhibits a weak relationship to QOL only through mental health.
  
  
  CONCLUSIONS
  Among children with epilepsy aged 8 to 14 years, mental health and social support should be areas of focus in the assessment of QOL. Controlling seizures is insufficient care for influencing the child's perception of their life.
authors.affiliation: From Health Care and Outcomes Research (N.F., A.M.D.), University Health Network, Toronto; Departments of Pediatrics (N.F., P.L.R., G.M.R.) and Psychiatry & Behavioural Neurosciences (D.L.S., C.E.C., M.H.B.), CanChild Centre for Childhood Disability Research (N.F., P.L.R., G.M.R.), and Offord Centre for Child Studies (C.E.C., M.H.B.), McMaster University, Hamilton; Institute of Health Policy Management and Evaluation (A.M.D.), Graduate Department of Rehabilitation Science (A.M.D.), and Department of Psychiatry (D.L.S.), University of Toronto; and School of Social Work (L.M.L.) McGill University, Montreal, Canada. fayedn@mcmaster.ca.
authors.forename: Nora
authors.initials: N
authors.lastname: Fayed
authors.affiliation: From Health Care and Outcomes Research (N.F., A.M.D.), University Health Network, Toronto; Departments of Pediatrics (N.F., P.L.R., G.M.R.) and Psychiatry & Behavioural Neurosciences (D.L.S., C.E.C., M.H.B.), CanChild Centre for Childhood Disability Research (N.F., P.L.R., G.M.R.), and Offord Centre for Child Studies (C.E.C., M.H.B.), McMaster University, Hamilton; Institute of Health Policy Management and Evaluation (A.M.D.), Graduate Department of Rehabilitation Science (A.M.D.), and Department of Psychiatry (D.L.S.), University of Toronto; and School of Social Work (L.M.L.) McGill University, Montreal, Canada.
authors.forename: Aileen M
authors.initials: AM
authors.lastname: Davis
authors.affiliation: From Health Care and Outcomes Research (N.F., A.M.D.), University Health Network, Toronto; Departments of Pediatrics (N.F., P.L.R., G.M.R.) and Psychiatry & Behavioural Neurosciences (D.L.S., C.E.C., M.H.B.), CanChild Centre for Childhood Disability Research (N.F., P.L.R., G.M.R.), and Offord Centre for Child Studies (C.E.C., M.H.B.), McMaster University, Hamilton; Institute of Health Policy Management and Evaluation (A.M.D.), Graduate Department of Rehabilitation Science (A.M.D.), and Department of Psychiatry (D.L.S.), University of Toronto; and School of Social Work (L.M.L.) McGill University, Montreal, Canada.
authors.forename: David L
authors.initials: DL
authors.lastname: Streiner
authors.affiliation: From Health Care and Outcomes Research (N.F., A.M.D.), University Health Network, Toronto; Departments of Pediatrics (N.F., P.L.R., G.M.R.) and Psychiatry & Behavioural Neurosciences (D.L.S., C.E.C., M.H.B.), CanChild Centre for Childhood Disability Research (N.F., P.L.R., G.M.R.), and Offord Centre for Child Studies (C.E.C., M.H.B.), McMaster University, Hamilton; Institute of Health Policy Management and Evaluation (A.M.D.), Graduate Department of Rehabilitation Science (A.M.D.), and Department of Psychiatry (D.L.S.), University of Toronto; and School of Social Work (L.M.L.) McGill University, Montreal, Canada.
authors.forename: Peter L
authors.initials: PL
authors.lastname: Rosenbaum
authors.affiliation: From Health Care and Outcomes Research (N.F., A.M.D.), University Health Network, Toronto; Departments of Pediatrics (N.F., P.L.R., G.M.R.) and Psychiatry & Behavioural Neurosciences (D.L.S., C.E.C., M.H.B.), CanChild Centre for Childhood Disability Research (N.F., P.L.R., G.M.R.), and Offord Centre for Child Studies (C.E.C., M.H.B.), McMaster University, Hamilton; Institute of Health Policy Management and Evaluation (A.M.D.), Graduate Department of Rehabilitation Science (A.M.D.), and Department of Psychiatry (D.L.S.), University of Toronto; and School of Social Work (L.M.L.) McGill University, Montreal, Canada.
authors.forename: Charles E
authors.initials: CE
authors.lastname: Cunningham
authors.affiliation: From Health Care and Outcomes Research (N.F., A.M.D.), University Health Network, Toronto; Departments of Pediatrics (N.F., P.L.R., G.M.R.) and Psychiatry & Behavioural Neurosciences (D.L.S., C.E.C., M.H.B.), CanChild Centre for Childhood Disability Research (N.F., P.L.R., G.M.R.), and Offord Centre for Child Studies (C.E.C., M.H.B.), McMaster University, Hamilton; Institute of Health Policy Management and Evaluation (A.M.D.), Graduate Department of Rehabilitation Science (A.M.D.), and Department of Psychiatry (D.L.S.), University of Toronto; and School of Social Work (L.M.L.) McGill University, Montreal, Canada.
authors.forename: Lucyna M
authors.initials: LM
authors.lastname: Lach
authors.affiliation: From Health Care and Outcomes Research (N.F., A.M.D.), University Health Network, Toronto; Departments of Pediatrics (N.F., P.L.R., G.M.R.) and Psychiatry & Behavioural Neurosciences (D.L.S., C.E.C., M.H.B.), CanChild Centre for Childhood Disability Research (N.F., P.L.R., G.M.R.), and Offord Centre for Child Studies (C.E.C., M.H.B.), McMaster University, Hamilton; Institute of Health Policy Management and Evaluation (A.M.D.), Graduate Department of Rehabilitation Science (A.M.D.), and Department of Psychiatry (D.L.S.), University of Toronto; and School of Social Work (L.M.L.) McGill University, Montreal, Canada.
authors.forename: Michael H
authors.initials: MH
authors.lastname: Boyle
authors.affiliation: From Health Care and Outcomes Research (N.F., A.M.D.), University Health Network, Toronto; Departments of Pediatrics (N.F., P.L.R., G.M.R.) and Psychiatry & Behavioural Neurosciences (D.L.S., C.E.C., M.H.B.), CanChild Centre for Childhood Disability Research (N.F., P.L.R., G.M.R.), and Offord Centre for Child Studies (C.E.C., M.H.B.), McMaster University, Hamilton; Institute of Health Policy Management and Evaluation (A.M.D.), Graduate Department of Rehabilitation Science (A.M.D.), and Department of Psychiatry (D.L.S.), University of Toronto; and School of Social Work (L.M.L.) McGill University, Montreal, Canada.
authors.forename: Gabriel M
authors.initials: GM
authors.lastname: Ronen
mesh_terms: D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004827:Epilepsy / Q000523:psychology*; D005260:Female; D006801:Humans; D007360:Intelligence; D007807:Language Tests; D008297:Male; D010290:Parents; D010379:Peer Group; D011788:Quality of Life / Q000523:psychology*; D057566:Self Report; D012944:Social Support; D011795:Surveys and Questionnaires
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