A clinical experience of psychiatric diagnostic assessment in epileptic patients of pediatric age: prospective study two years after epilepsy onset.

Introduction According to the scientific literature, the psychiatric comorbidity in children with epilepsy increase if compared to general paediatric population, with a prevalence of anxiety-depressive disorders, thought, attentional, and social problems. The numerous studies on the temporal relationship between epilepsy and psychopathology speculate about common etiopathogenic pathways to both disorders. Method A sample of 50 children (age 4-18) with new-onset epilepsy (CNOE), in the absence of mental retardation and non- neurological comorbidities, were subjected to periodical psychiatric and psychological diagnostic assessment (every 6 months ) by clinical interview, dimensional and categorical psychometric instruments and, where necessary, specific psychometric tests. The evaluation also explored the cognitive and temperamental profile, family dynamics, and quality of life. The perspective design of the study allowed to analyze the sample from the demographic, psychosocial and epileptologic profile, by following the natural evolution of factors involved with a potential psychiatric comorbidity. Results Baseline data (T0) show psychiatric comorbidity with higher rates for anxiety-depressive disorders (16% with a dominant anxiety component), attentional problems (13%) and thought problems (13%). A reduction of social skills also emerged. Data at 6 months (T6) show a reduction of some of the raised issues and an improvement in social skills, suggesting a stressor role of epilepsy itself. Data to the conclusion of the follow-up remain to be analyzed (end of recruitment in June 2013). Nevertheless analysis at T0 and T6 show numerous associations between psychopathology and neurologic, demographic, and psychosocial variables. Conclusions The high prevalence of psychiatric comorbidity in CNOE and its relationship with the variables here considered support the hypothesis of a possible CNS dysfunction common to both pathological processes: epilepsy and psychopathology. However, the importance of stressing factors at the time of diagnosis in the evolution of psychopathology cannot be ignored.