Abstracts

The purpose of this investigation was 1) to characterize the rate and nature of lifetime-to-date psychiatric co-morbidity in newly diagnosed children with epilepsy, 2) to determine whether and to what degree psychiatric co-morbidity antedated epilepsy onset, and 3) to identify neuropsychological correlates of psychiatric comorbidity in new onset epilepsy. Study participants included 81 children ages 8-18. There were 46 children with newly diagnosed epilepsy (localization related=29, primarily generalized=17) and 35 healthy controls who were first-degree cousins. Average age of the sample was 12.8 years. All participants were recruited from two major health care systems in the Midwest. Each parent and child underwent a structured interview using the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS), and each child was administered the Children[apos]s Memory Scale (CMS) and Wechsler Abbreviated Scale of Intelligence (WASI). Significantly (p [lt] 0.01) more children with new onset epilepsy met criteria for a lifetime-to-date DSM-IV diagnosis compared to controls (31.4% vs. 69.6%). In characterizing children with new onset epilepsy, 34.8% met criteria for affective/anxiety disorders, 15.2% for disruptive disorders and 19.6% had both affective/anxiety and disruptive disorders. Episodes of psychiatric co-morbidity antedated the first recognized seizure in 48% of new epilepsy onset cases. Comparing children with new onset epilepsy who met criteria for a DSM-IV diagnosis to those who did not have a psychiatric diagnosis, the former had a significantly lower Verbal IQ. However, there were no differences in Performance IQ and memory (verbal or visual) compared to new onset epilepsy cases who did not meet criteria for a psychiatric diagnosis and to healthy controls. Significantly elevated rates of lifetime-to-date psychiatric comorbidity are present in children with recent onset epilepsy. Frequently, the psychiatric disorder is evident prior to the first recognized seizure and is associated with lower Verbal IQ but not Performance IQ or memory impairment. (Supported by NIH NS RO1-44351, MO1 RR03186 (GCRC), and F32 MH649882.)