Abstracts

Rationale: The impact of family and caregiver factors on symptoms of anxiety and depression in children with epilepsy has not been adequately addressed. This study evaluated these associations in a cohort of children and adolescents with medically refractory epilepsy. Methods: Data were derived from a multicenter prospective cohort study evaluating 46 children (ages 6-11 years) and 68 adolescents (ages 12-18 years) with epilepsy. This study is unique in evaluating the impact of multiple child (including age, sex, epilepsy-related variables and IQ), caregiver (including age, sex, education, employment, and symptoms of anxiety and depression) and family characteristics (including household income, and validated measures of family functioning, family mastery and social support, and family demands) on self-reported symptoms of anxiety and depression. Children completed the Revised Children's Anxiety and Depression Scale. Adolescents completed the Quick Inventory of Depressive Symptomatology and Generalized Anxiety Disorder 7-item scale to evaluate depressive and anxiety symptoms, respectively. Results: Among children, symptoms of depression were associated with a higher proportion of life with seizures (߽.360, p=.014), caregiver depression (߽.405, p=.005), poor family functioning (߽.405, p=.005) and poor family mastery and social support (߽.326, p=.027); in multivariable analyses, proportion of life with epilepsy remained significant. No significant predictors of anxiety were found. Among adolescents, depression was associated with caregiver unemployment (߽.345, p=.004) and anxiety (߽.371, p=.002), low household income (߽.301, p=.016), poor family mastery and social support (߽.303, p=.012) and greater family demands (߽.290, p=.017); in multivariable regression, caregiver anxiety remained significant. Greater anxiety symptoms among adolescents were associated with females (߽.337, p=.005) and caregiver depression (߽.247, p=.043) and anxiety (߽.401, p=.001); in multivariable analyses female sex and caregiver anxiety remained significant. Conclusions: These findings highlight the central role of caregiver and family characteristics, on patient ?" particularly adolescent ?" symptoms of anxiety and depression. These characteristics are amenable to intervention, suggesting an approach to preventing or treating these symptoms of psychological distress. Funding: Supported by a research grant from the Canadian Institutes of Health Research.