Abstracts

Chronic epilepsy can be associated with significant psychiatric co-morbidity. The nature, timing, and etiology of this co-morbidity remain to be fully characterized. Prior investigations of children with [italic]chronic[/italic] epilepsy using standardized psychiatric interview procedures (e.g., K-SADS) have revealed high rates of psychiatric disorder (approximately 50%) which could have been apparent from the onset of the disorder or developed over time. This investigation examined children with new onset epilepsy ([lt] 12 months since diagnosis) to determine whether psychiatric co-morbidity was present closer in time to the onset of the epilepsy. Of an anticipated final sample of 75 children with new onset epilepsy and 75 controls, this preliminary report describes results from 24 children; 15 with epilepsy (localization-related = 8, primary generalized = 7) and 9 age-matched controls (first degree cousins). Recruitment is ongoing from two major health care systems in Wisconsin. Average age of the sample is 13.2 years (range 8-18) and mean age of diagnosis for the epilepsy sample is 11.6 years. Subjects and their mothers independently underwent a standardized psychiatric interview (K-SADS) and the primary caretaker completed a Child Behavior Checklist (CBCL). K-SADS revealed that 46.7% of the children with epilepsy and 11.1% of the controls had a current Axis I disorder. Lifetime-to-date Axis 1 disorders were found in 60% of the epilepsy and 22.2% of the control group. The most common current disorders in the epilepsy group were mood (major depression, depressive disorder NOS) and anxiety (OCD, separation anxiety) disorders. There were no significant differences between the groups on the CBCL summary scores. These preliminary findings indicate that children with new onset epilepsy exhibit significantly elevated rates of current and lifetime-to-date Axis I disorders compared to age and gender matched controls. This elevated psychiatric co-morbidity is present close in time to onset of the disorder, and the increased rates of lifetime-to-date disorders would appear to be consistent with the hypothesis that psychiatric co-morbidity may even be elevated prior to the diagnosis of epilepsy and associated with neurobiological factors that led to the development of epilepsy. (Supported by Findings supported by: NIH NS R01-44351, F32 MH649882, and MO1 RR03186 (GCRC).)