Abstracts

Rationale: Children with epilepsy are at risk for negative self-esteem, perceived stigma, and poor social interactions, which may prevent them from reaching their full potential. It is well known that young adults with childhood onset epilepsy have poor psychosocial outcomes. Previous studies have not found children with epilepsy to have lower self-esteem compared to norms despite the difficulties they face. The purpose of this study was to evaluate the impact of duration of epilepsy on self-concept and knowledge of epilepsy in children with epilepsy.Methods: In the setting of an epilepsy clinic, children with at least one unprovoked seizure and normal development were asked to complete two questionnaires: Knowledge of Epilepsy (Child Version, KOE) and the Self-Perception Profile for Children (8-12 yrs) or Adolescents (13-20 yrs) (SPPC or SPPA). Children with febrile or non-epileptic seizures were excluded. Data was entered in SPSS version 19. Group comparisons were made using a t-test. The ANOVA analysis was used to assess relationships between KOE and the SPPC/SPPA. Normative data for the SPPC and SPPA were used as a comparison group. Results: Sixty-three subjects (27 children 8-11 yrs, 36 adolescents 12-20 yrs; 27 males, 36 females) completed at least one questionnaire. 8 subjects were newly diagnosed and 55 had established epilepsy. The mean duration of epilepsy was 4.5 years +/-4.3, mean onset of epilepsy was 8.9 years +/-4.48, and seizure frequency was daily (9%), weekly (7.5%), monthly (19.4%), less than monthly (37.3%), and seizure free (17.9%). On the SPPC children with epilepsy perceived greater global self-worth, better behavioral conduct and greater physical appearance than a normal population (p<.01 for all measures). On the SPPA adolescents scored higher in romance appeal than peers (p=.012). There was no association between KOE scores or self-concept with duration of epilepsy or seizure frequency. Lower global worth was associated with an earlier age of onset of seizures (p=.015) and there was a trend towards higher global worth in children with new onset epilepsy as compared to those with established epilepsy (p=.053). On the SPPC males scored higher than females in athletic competence (p=.025) and on the SPAA males scored higher than females in athletic competence and physical appearance (p=.001, p=.017). Adolescent males had greater KOE than did females (p=.045). Conclusions: Children and adolescents with epilepsy do not have decreased self concept compared to healthy peers and duration or severity of epilepsy do not impact KOE or self-concept. Children with early onset epilepsy are at risk for lower self esteem and may require further assessment and intervention.