Abstracts

Hoare et al. (1984) found an increase of progression over time in psychopathology in the siblings of children with epilepsy but not in the siblings of children with diabetes. These findings suggested that epilepsy in a family affects the emotional well-being of the unaffected siblings. The present study examined if the unaffected siblings of children with complex partial seizures (CPS) have psychopathology rates similar to the probands or normal children. It also determined the association of these rates with proband seizure-related (i.e. seizure control, age of onset, duration of illness, AEDs) and cognitive variables, as well as with sib variables, such as IQ and whether the sib is older or younger than the proband.
Psychopathology was assessed using the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) administered to 20 children with CPS, 16 unaffected siblings, and 63 typically developing children, aged 6-14 years. The parents were also separately interviewed about their children with the K-SADS. The WISC-III was administered to each child. Information on seizure frequency, current AEDs and age of onset of CPS was obtained from the parent. Logistic regression was used to examine whether presence or absence of psychopathology in siblings was related to the variables of interest.
A DSM-IV diagnosis found in 60% of the CPS and 50% of the sibs was significantly more frequent (p [lt] 0.001) than in the normal subjects. Among the sibs, 78% with a psychiatric diagnosis were older than the proband, whereas only 33% of those without a psychiatric diagnosis were older than the proband (p [lt] .05). Other sib variables such as IQ scores and proband seizure-related (i.e. seizure control, age of onset, duration of illness, AEDs) and cognitive variables were unrelated to sib psychopathology rates. In terms of the types of psychiatric diagnoses, 29% of the sibs had disruptive disorders (i.e., attention deficit hyperactivity, oppositional defiant, conduct disorder), 42% had affective/anxiety disorders, and 29% had both disruptive and affective/anxiety disorders.
From a mental health services perspective, the older unaffected siblings of children with CPS might need intervention to help them deal with the proband[apos]s illness. Similar high rates of psychopathology in the unaffected siblings and in the probands unrelated to proband seizure-related variables imply familial rather than seizure-related effects.
[Supported by: RO1 NS 32070]