Abstracts

Rationale: Epidemiological and community studies conducted over the past twenty-six years have confirmed high rates of psychopathology (i.e., psychiatric diagnoses, behavior and emotional problems) in children with new onset and chronic epilepsy both with and without intellectual disability who are treated medically or by epilepsy surgery. Despite prevalent psychiatric comorbidities in pediatric epilepsy, only one-third of children with average intelligence have had a psychiatric, psychological, neuropsychological, speech and language evaluation, or treatment of these comorbidities. The goal of this study was to assess the attitudes, general knowledge, and comfort in managing psychopathology in pediatric epilepsy among behavioral health providers. Methods: An online questionnaire was developed for behavioral health professionals (BHP) with content validity reviewed by 3 experts in the area of psychopathology in pediatric epilepsy. A link to the questionnaire, which measured general knowledge, attitude toward and comfort in management of psychopathology in children with epilepsy, was e-mailed to clinical directors of 9 government-funded behavioral health agencies providing services primarily to children and youth requesting distribution to staff. 171 of 500 (33%) BHP participated in this cross-sectional cohort study. 146 (85%) completed the survey. Group comparisons were made using t-tests and ANOVA's. The BHP surveyed are included in Table 1. Results: Significant differences in attitude, knowledge, or comfort in managing psychopathology in children with epilepsy among the disciplines (p=0.6) outlined in Table 1were not identified. However BHP providing services in an institution, such as a school or hospital, possessed better attitudes (p=0.003) and more comfort in managing psychopathology in children with epilepsy (p=0.002.) than those who provided treatment in the community. BHP's who have witnessed a seizure had significantly higher comfort in management scores (p=0.001). Similarly BHP who knew someone with epilepsy indicated a significantly better attitude (p=0.003) and more comfort in managing (p=0.007) psychopathology in epilepsy. Of the 146 BHP surveyed, 84% indicated a desire for training about providing behavioral health services to children with epilepsy. Conclusions: In this first study assessing attitude, general knowledge and comfort in managing psychopathology of BHP in children with epilepsy, we found that previous exposure to seizures has a significant impact on BHP's attitudes and comfort in managing psychopathology in children with epilepsy. Additionally, community-based BHP express a lack of confidence and the knowledge needed to adequately manage psychopathology in children with epilepsy. Our results emphasize an overwhelming need to educate and establish relationships with BHP so that they play an effective role in the multi-disciplinary care of children with epilepsy.