Abstracts

Psychopathology, subtle IQ deficits, and impaired use of language in organizing and formulating thoughts (thought disorder), present in children with cryptogenic complex partial seizures (CPS), also run in families. The present study compared behavior, cognition, and thought disorder in the siblings of children with CPS to their CPS probands and to children without epilepsy. It also determined the association of these sib variables with severity of proband illness using proband cognitive and seizure-related variables., DSM-IV diagnoses were made using structured psychiatric interviews administered to 48 children with CPS, 25 unaffected siblings, 43 typically developing children, and 23 siblings of the normal probands, aged 6-16 years and their parents. The WISC-III was administered to each child. Information on seizure variables was obtained from the parent. Mixed general linear models examined group differences in the outcome variables (psychiatric diagnoses, IQ and thought disorder scores), with family as a random effect, group (CPS/ CPS sib/ Normal/Normal sib) as a fixed effect and age, gender, ethnicity, socioeconomic status as covariates. Linear and logistic regression models were used to examine whether psychopathology, IQ and thought disorder scores in siblings were related to the sibling and proband variables of interest., 28% of the sibs had a DSM-IV diagnosis, significantly more frequently than in the normal subjects (10% in the normal probands and 9% in siblings of normal probands) and less frequently than in the CPS probands (40%). 71% of the siblings with a psychiatric diagnosis had a CPS proband with prolonged seizures compared to only 28% of those without a psychiatric diagnosis. Siblings also scored significantly worse compared to the normal subjects and better than the CPS subjects in Full-Scale IQ, Verbal IQ, and overall thought disorder scores. Sibling Full Scale and Verbal IQ scores were related to proband IQ scores, history of prolonged seizures, bilateral or left lateralization of EEG findings, as well as longer duration of proband illness. Sibling thought disorder score was related to bilateral or left lateralization of EEG findings and increased duration of proband illness., Significantly higher psychopathology rates, lower IQ and more thought disorder in CPS siblings are a function of proband seizure-related variables, an indirect measure for parental involvement in the proband[apos]s illness. The findings suggest a possible cumulative impact of epilepsy on the cognition and communication skills of the unaffected siblings. Although preliminary, these findings underscore the importance of increasing the awareness of clinicians, parents, and educators to the needs of the siblings of children with CPS., (Supported by NS32070 and MH067187.)