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(Abst. 1.288), 2019

Medical and Psychiatric Diagnoses 10 Years After Diagnosis of Childhood Onset Epilepsy
Authors: Rachel Friefeld Kesselmayer, University of Wisconsin-Madison; Jana E. Jones, University of Wisconsin-Madison; Dace N. Almane, University of Wisconsin-Madison; Alanna Kessler-Jones, University of Wisconsin-Madison; Bruce P. Hermann, University of Wisconsin-Madison
Content: Rationale: The purpose of this study was to describe the pattern of medical and psychiatric comorbidity in children with childhood onset epilepsy at baseline and 10-years post epilepsy diagnosis. Methods: Children with uncomplicated childhood onset epilepsy (age 8-18) (i.e., without intellectual disability or neurological impairment) were evaluated at baseline within 12 months of epilepsy diagnosis and 10 years later. The Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) was completed to assess current and lifetime psychiatric diagnoses consistent with the DSM-IV. At 10-year follow-up participants (now age 18-28), participated in a psychiatric interview using the Composite International Diagnostic Interview (CIDI). Medical comorbidity data at baseline were collected via interview and via online survey 10 years later. Univariate analyses and binomial logistic regression compared persons with epilepsy to controls at baseline and follow up. Results: A total of 108 individuals, 53 with epilepsy and 55 healthy controls participated in both baseline and 10-year follow-up evaluations. Focal or generalized epilepsy was diagnosed in 55% and 42% of participants, respectively. At initial evaluation 62% of children with epilepsy presented with any psychiatric or medical comorbidity; 49% psychiatric only, 8% medical only, and 6% both. Among healthy controls 35% presented with any psychiatric or medical comorbidity; 27% psychiatric only, 7% medical only, and none with both. A current psychiatric comorbidity at baseline was increased by having a diagnosis of epilepsy (odds ratio [OR] = 3.22; 95% CI: 1.44-7.19). At follow-up, any psychiatric or medical comorbidity was present among 59% of individuals with epilepsy; 24% psychiatric only, 18% medical only, and 18% both. Among healthy controls, 60% had any psychiatric or medical comorbidity; 20% psychiatric only, 25% medical only, and 15% both. Epilepsy was no longer a significant predictor of psychiatric comorbidity at follow-up. The likelihood of medical comorbidity was not predicted by epilepsy at any point. Tables 1 and 2 depict specific rates of medical and psychiatric comorbidity. Conclusions: Comparing individuals with childhood onset epilepsy to controls at baseline and 10-year follow-up, results from this study implicate the importance of early identification and treatment of psychiatric comorbidity at time of epilepsy diagnosis as psychiatric comorbidity remains problematic 10 years following diagnosis. Though overall rates of any comorbidity appear stable across individuals with epilepsy, rates increase across control participants, suggesting differences in comorbidity trajectory. Further investigation is warranted to determine factors associated with stable rates of psychiatric and medical comorbidity 10-years post-epilepsy diagnosis. Funding: (Jones, Hermann) NIH (R01NS04435)
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