Abstracts

A high comorbidity between attention deficit / hyperactivity disorder (ADHD) and epilepsy has been noted in the literature. Prevalence rates and associations between type of epilepsy and ADHD are disputed. To estimate the need for better-tailored health care, we screened pediatric outpatient admissions to the Swiss Epilepsy Center for possible ADHD using translations of the Conners[apos] Parent Rating Scale [ndash] Revised (CPRS-R) and, to assess a wider range of behavioral problems, the Strengths and Difficulties Questionnaire (SDQ). Our goal was to determine the frequency and severity of attentional disorders in referrals to our clinic. We also investigated type of epilepsy, age and gender as possible associated risk factors., Parents of children with epilepsy aged 4-16 were requested to complete both questionnaires. Inclusion criteria were: a diagnosis of epilepsy, no mental impairment, and fluency in German. All children underwent a neuropediatric examination with EEG. Epilepsy was diagnosed using ICD-10 criteria. The SDQ is a screening questionnaire for 4 -16 year-olds that assesses positive and negative behavioral attributes. The CPRS-R rates 27 behavioral attributes relating to ADHD. We used a cut-off of T score [ge] 66 in the CPRS-R to indicate probable presence of ADHD and a score of [ge] 17 total difficulties score in the SDQ as abnormal., Completed questionnaires were obtained from 51 patients. The most frequent reasons for exclusion were no epilepsy diagnosis (10%) and mental impairment (4%). The most frequent type of epilepsy was symptomatic epilepsy (45%), followed by generalized idiopathic epilepsy (10%). The mean age was 11.2 years with 27 females and 24 males. 29 children (57%) did not exceed the critical values in either questionnaire. 19 (37%) were above the cut-off on the CPRS and 11 (22%) in both questionnaires, thus meeting strict criteria for the probably presence of ADHD. The two scales were moderately correlated (r = 0.526), with the CRS-R being the more sensitive instrument. We found no correlation in either questionnaire with age, sex or type of epilepsy and critical scores., Parents[apos] ratings of ADHD symptoms in their children were highly elevated as compared to base rates. We found 22% to meet strict criteria for probable presence of ADHD. The majority with critical CPRS values also scored in the critical range on the SDQ, suggesting a wider spectrum of behavioral problems than merely ADHD symptoms exist in this population. We found no effects of age or type of epilepsy on critical scores in either questionnaire. Whereas a sex bias in favor of males is found in non-epileptic ADHD populations, we found no such association. Our findings of high rates of ADHD symptoms in children with epilepsy highlights the need for increased awareness of the comorbidity of these disorders as well as for targeted medical or psycho-behavioral treatment.,