Abstracts

Earlier studies have shown that psychopathology (Caplan et al., 1998; Ott et al., 2000) and impaired use of language in organizing and formulating thoughts (i.e., thought disorder)(Caplan et al., 2001, 2002) are related to IQ and seizure control in children with complex partial seizures (CPS) . Austin et al. (2001) reported psychopathology prior to new onset seizures in children and an association between prior psychopathology and subsequent seizures. In the siblings of children with epilepsy, however, the development over time of psychopathology suggests that epilepsy within the household might have a cumulative environmental effect on the development of psychopathology (Hoare, 1984). Given these prior findings and the heritability of psychopathology (Kendler, 2001), thought disorder (Gambini et al., 1997), and IQ (Wright et al., 2001), this study examined if the neurobehavioral deficits of CPS children are associated with familial factors.
The Kiddie Formal Thought Disorder Rating Scale, the Kiddie Schedule for Affective Disorders and Schizophrenia, and the WISC-III were administered to 20 children with CPS, 16 unaffected siblings, and 63 typically developing children, aged 9.9(2.57), 10.1(2.02), 10.1(2.07) years, respectively. DSM-IV diagnoses were based on both child and parent K-SADS interviews. Mixed general linear models were used to examine group differences in the outcome variables (thought disorder scores, psychiatric diagnoses, IQ scores), with family as a random effect, group (CPS/ CPS sib/ Normal) as a fixed effect and age and gender as covariates.
Despite mean average IQ scores, ANCOVAs with age and gender as covariates demonstrated that both the CPS patients ([underline]p[/underline][lt]0.007) and their sibs ([underline]p[/underline][lt]0.04) had significantly higher rates of psychiatric diagnoses, lower Verbal IQ scores, and more disorganized thinking than the normal subjects. There were no significant differences, however, in these measures between the probands and sibs. In contrast, other aspects of thought disorder (i.e., under use of linguistic ties that connect what is said across sentences), Full Scale IQ, and Performance IQ were significantly impaired in the probands compared to both their sibs ([underline]p[/underline][lt]0.04) and the normal children ([underline]p[/underline][lt]0.002). There were no signficant differences between the sibs and normal subjects on these measures.
These preliminary findings suggest that the presence of psychiatric diagnoses, certain aspects of thought disorder (i.e., disorganized thinking), and Verbal IQ might reflect familial effects in children with CPS. From the methodological perspective, they highlight the need to control for familial factors when studying the effects of CPS on children[rsquo]s neurobehavioral deficits. Clinically, they suggest that the siblings of children with CPS might be at risk for difficulties with their behavior, social communication, and verbal IQ.
[Supported by: RO1 NS 32070 ]