Abstracts

Rationale: Youth with epilepsy (YWE) can experience limitations due to seizure activity, medication side effects, and comorbid psychological conditions (e.g., ADHD, learning disorders, depression, anxiety). The primary goal of epilepsy treatment is no seizures, no side effects, and best quality of life. Health-related quality of life (HRQOL) captures the impact of a chronic condition on an individual’s physical, emotional, social, and school functioning. YWE, especially those with comorbidities, can have compromised HRQOL; yet, the impact of premorbid psychological symptoms on HRQOL over the course of treatment is unclear. Within the New Onset Seizure (NOS) Clinic, an integrated model of epilepsy and psychological care, psychological screening is conducted at the diagnostic visit, along with targeted psychological interventions during routine care. The study aimed to assess the impact of baseline psychological symptoms, along with routine psychological care, on HRQOL trajectories for YWE newly diagnosed. Methods:  A total of 397 YWE (Mage=9.0±4.3 years; 84.4% Caucasian; 33.8% localization-related epilepsy, 42.6% generalized epilepsy, 22.7% unclassified epilepsy) who received care in the NOS Clinic between July 2011 and December 2015, were included. Chart reviews extracted sociodemographic and medical data. The Behavioral Assessment Scale for Children-2nd Edition: Parent Rating Scale (BASC-2:PRS) was completed at diagnosis to assess baseline psychological functioning (i.e., Externalizing Symptoms, Internalizing Symptoms, Behavioral Symptoms Index). The PedsQLTM: Parent Report (PedsQLTM:PR) was completed at all visits to measure HRQOL (i.e., Physical, Emotional, Social School subscales, Total scale). The sample was divided into two cohorts based on baseline clinical psychological elevations: absence/presence. Latent Growth Curve Modeling was utilized while controlling for seizure absence/presence and medication side effects. Results: Youth with baseline clinical psychological elevations had significantly lower HRQOL at baseline than those without (p < .001). Youth with baseline clinical psychological elevations of Externalizing Symptoms had significant improvements in Total HRQOL (b = 2.42, p = .03) over time than those without. Youth with baseline clinical psychological elevations on Internalizing Problems had significant improvements in Social (b = 3.25, p = .009), School (b = 3.03, p = .03), Physical (b = 2.76, p = .02), and Total functioning (b = 2.92, p = .004) than those without. Youth with baseline clinical psychological elevations on the Behavioral Symptoms Index had significant improvements in Social (b = 3.21, p = .01) and Total functioning (b = 2.57, p = .02), compared to those without. Conclusions: Despite lower HRQOL at diagnosis for YWE with psychological symptoms, routine psychological care enhanced HRQOL for these youth such that both cohorts reported comparable HRQOL one year post-diagnosis. Integrated epilepsy and psychological care can proactively address psychological symptoms and optimize functioning in YWE. Funding: N/A