Highlights
- •Of adolescents with epilepsy (AWE), 18.3% had at least one emotional or behavioral problem.
- •Female and older AWE had a higher level of internalizing problems than male and younger AWE.
- •A quarter of parents of AWE felt stigma towards their children with epilepsy.
- •Parental perception of stigma was significantly associated with higher psychopathology in AWE.
Abstract
Purpose
We evaluated self-reported psychopathology in adolescents with epilepsy (AWE) and
determined which types of psychopathology were associated with the parental perception
of stigma towards AWE.
Methods
This was a cross-sectional, multicenter study of 289 adolescents aged 11 to 18 years.
Psychopathology was evaluated using the Youth Self-Report scale, which consists of
eight narrowband and three broadband syndrome scales. We analyzed the raw score and
T-score of each syndrome scale. The parental perception of stigma was assessed using
the modified three-item Epilepsy Stigma Scale.
Results
Of the 289 AWE (180 boys and 109 girls), 18.3% had at least one emotional or behavioral
problem in the clinical range. Social problems were the most common (10.0%), followed
by attention problems (6.9%) and aggressive behaviors (4.2%). Externalizing problems
(11.8%) were two times more common than internalizing problems (6.2%). Females and
older AWE had a higher level of internalizing problems. Social problems were more
common in girls (15.6%) than in boys (6.7%), whereas thought problems were more common
in boys (3.9%) than in girls (0%). Epilepsy-related factors, especially antiseizure
medication polytherapy, were significantly associated with various emotional and behavioral
problems. A quarter of parents felt stigma towards their children with epilepsy. Male
sex, antiseizure medication polytherapy, and longer duration of epilepsy were more
likely to be associated with the parental perception of stigma. Parental perception
of stigma was significantly associated with psychopathology in AWE, particularly externalizing
problems and social problems.
Conclusions
Emotional and behavioral problems in AWE are common and vary depending on demographic,
clinical, and parental factors. Early identification and proper management of these
problems are crucial for decreasing comorbid psychopathology in AWE.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Epilepsy & BehaviorAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Prevalence and incidence of epilepsy: A systematic review and meta-analysis of international studies.Neurology. 2017; 88: 296-303https://doi.org/10.1212/WNL.0000000000003509
- Predictors of health-related quality of life and costs in adults with epilepsy: a systematic review.Epilepsia. 2011; 52: 2168-2180https://doi.org/10.1111/j.1528-1167.2011.03213.x
- Adolescents with active or inactive epilepsy or asthma: a comparison of quality of life.Epilepsia. 1996; 37: 1228-1238https://doi.org/10.1111/j.1528-1157.1996.tb00558.x
- A population survey of mental health problems in children with epilepsy.Dev Med Child Neurol. 2003; 45: 292-295https://doi.org/10.1017/s0012162203000550
Organization WH. The second decade: improving adolescent health and development. In: World Health Organization; 2001.
- Psychopathology in children with epilepsy: a meta-analysis.J Pediatr Psychol. 2005; 30: 453-468https://doi.org/10.1093/jpepsy/jsi071
- Systematic Review and Meta-Analysis of Anxiety and Depression in Youth With Epilepsy.J Pediatr Psychol. 2020; 45: 133-144https://doi.org/10.1093/jpepsy/jsz099
- Family factors and psychopathology in children with epilepsy: a literature review.Epilepsy Behav. 2005; 6: 488-503https://doi.org/10.1016/j.yebeh.2005.03.006
- Stigma: notes on managing a spoiled identity.Simon and Schuster, New York1963
- The stigma of epilepsy: a European perspective.Epilepsia. 2000; 41: 98-104https://doi.org/10.1111/j.1528-1157.2000.tb01512.x
- Factors associated with stigma and depressive symptoms in family members of patients with epilepsy.Epilepsy Behav. 2020; 110107129https://doi.org/10.1016/j.yebeh.2020.107129
- The effects of perceived stigma and psychological over-control on the behavioural problems of children with epilepsy.Seizure. 1997; 6: 383-391https://doi.org/10.1016/s1059-1311(97)80038-6
- Identifying risk factors for maternal depression in families of adolescents with epilepsy.J Spec Pediatr Nurs. 2002; 7: 71-80https://doi.org/10.1111/j.1744-6155.2002.tb00153.x
- Russell S.T. Crockett L.J. Chao R.K. Asian American parenting and parent-adolescent relationships. Springer New York, New York, NY2010
- Relationship of epilepsy-related factors to anxiety and depression scores in epileptic children.J Child Neurol. 2002; 17: 37-40
- Psychopathology in children and adolescents with epilepsy: an investigation of predictive variables.Epilepsy Behav. 2008; 12: 136-144https://doi.org/10.1016/j.yebeh.2007.08.003
- Epilepsy and associated psychopathology in young people with intellectual disability.J Paediatr Child Health. 2000; 36: 172-175https://doi.org/10.1046/j.1440-1754.2000.00487.x
- Internalizing and externalizing symptoms in preschool and school-aged children with epilepsy: Focus on clinical and EEG features.Epilepsy Behav. 2018; 79: 68-74https://doi.org/10.1016/j.yebeh.2017.10.004
- Symptoms of anxiety and depression and family's quality of life in children and adolescents with epilepsy.Epilepsy Behav. 2018; 79: 146-153
- Korean QoL in Epilepsy Study Group. Family factors contributing to emotional and behavioral problems in Korean adolescents with epilepsy.Epilepsy Behav. 2016; 56: 66-72https://doi.org/10.1016/j.yebeh.2016.01.010
Achenbach TM, Rescorla LA. Manual for the ASEBA school-age forms & profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, and Families; 2001.
- Korean version of Youth Self Report.Huno Consulting Inc., Seoul2011
- Felt versus enacted stigma: a concept revisited. Evidence from a study of people with epilepsy in remission.Soc Sci Med. 1994; 38: 269-274https://doi.org/10.1016/0277-9536(94)90396-4
- Korean QoL in Epilepsy Study Group. Contribution of the family environment to depression in Korean adults with epilepsy.Seizure. 2015; 25: 26-31https://doi.org/10.1016/j.seizure.2014.11.011
- Emotional and behavioral problems in children with epilepsy attending the pediatric neurology clinic at a referral hospital in Kenya.Epilepsy Behav. 2021; 114107477https://doi.org/10.1016/j.yebeh.2020.107477
- Psychiatric Symptoms and Parental Stress in Children and Adolescents With Epilepsy.Front Neurol. 2021; 8778410https://doi.org/10.3389/fneur.2021.778410
- Behaviour problems in children and adolescents with seizure disorder: associations and risk factors.Seizure. 2005; 14: 190-197https://doi.org/10.1016/j.seizure.2005.01.007
- Mental health problems in children and adolescents referred to a national epilepsy center.Epilepsy Behav. 2007; 10: 255-262https://doi.org/10.1016/j.yebeh.2006.11.011
- Cross-cultural differences in survey response patterns.Int Mark Rev. 2007; 24: 127-143https://doi.org/10.1108/02651330710741785
- Disorders of childhood and adolescence: gender and psychopathology.Annu Rev Clin Psychol. 2008; 4: 275-303https://doi.org/10.1146/annurev.clinpsy.3.022806.091358
- Adolescent self-report of emotional and behavioral problems: interactions of genetic factors with sex and age.J Can Acad Child Adolesc Psychiatry. 2011; 20: 35-52
- Gender differences in the diagnosis of mental disorders: conclusions and controversies of the DSM-IV.Psychol Bull. 1998; 123: 260-278https://doi.org/10.1037/0033-2909.123.3.260
- Trends in childhood and adolescent internalizing symptoms: results from Swedish population based twin cohorts.BMC Psychol. 2019; 7: 50https://doi.org/10.1186/s40359-019-0326-8
- Predictors of internalising behaviour problems in adolescents.in: Mathiesen K.S. Sanson A.V. Karevold E.B. Tracking opportunities and problems from infancy to adulthood: 20 years with the TOPP study. Hogrefe Publishing, 2018: 67-80
- Psychopathology in pediatric epilepsy: role of antiepileptic drugs.Front Neurol. 2012; 3: 163https://doi.org/10.3389/fneur.2012.00163
- Psychiatric comorbidities in pediatric epilepsy.Curr Psychiatry Rep. 2020; 22: 77https://doi.org/10.1007/s11920-020-01195-8
- Examining relations between neuropsychological and clinical epilepsy-specific factors with psychopathology and adaptive skills outcomes in youth with intractable epilepsy.Epilepsy Behav. 2020; 110: 107171https://doi.org/10.1016/j.yebeh.2020.107171
- Behavioral issues involving children and adolescents with epilepsy and the impact of their families: recent research data.Epilepsy Behav. 2004; 5: S33-S41https://doi.org/10.1016/j.yebeh.2004.06.014
- Perceived stigma in Korean adolescents with epilepsy: Effects of knowledge about epilepsy and maternal perception of stigma.Seizure. 2015; 24: 38-43
- Seizure severity in children with epilepsy is associated with their parents' perception of stigma.Epilepsy Behav. 2016; 63: 42-45https://doi.org/10.1016/j.yebeh.2016.07.028
- Ratings of relations between DSM-IV diagnostic categories and items of the CBCL/6–18, TRF, and YSR.University of Vermont, Dept Psychiatry, Burlington VT2001
Article info
Publication history
Published online: December 07, 2022
Accepted:
November 21,
2022
Received in revised form:
November 10,
2022
Received:
September 21,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
