Abstracts

Rationale: While children with epilepsy have higher rates of psychiatric disorders than healthy peers and children with other medical conditions, the natural history of these disorders is unknown. The purpose of this study was to identify risk factors associated with having an Axis I disorder at baseline and 2-year follow-up in children with recent onset epilepsy.Methods: Participants were 105 children with recent-onset epilepsy (56 focal, 49 generalized) and 73 healthy controls with a mean age of 12.34 years. Participants completed an assessment at baseline and 2-year follow-up. The child and parent completed the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) (Kaufmann et al. 1997). Current Axis I diagnoses were examined in the following manner: No Axis I diagnosis at baseline or 2-year follow-up (0 Axis I), single Axis I diagnosis at either baseline or 2-year follow-up (1 Axis I), and an Axis I diagnosis at both baseline and 2-year follow-up (2 Axis I). Family history of psychopathology was obtained based on first degree relatives. Two multinomial logistic regression models were tested: Model 1 included entire sample of participants and assessed the following predictors: group, gender, family history of psychopathology, baseline age and IQ. Model 2 included only children with epilepsy and assessed the following predictors: epilepsy syndrome, gender, baseline IQ, AEDs, and epilepsy onset age.Results: Model 1 was significant indicating that at least one of the predictors in the model was not equal to zero, chi2 (52.56)=325.52, p < 0.001. There were no significant predictors for 1 vs. 0 Axis I diagnosis. Significant predictors for 2 vs. 0 Axis I diagnosis were group, family history of psychopathology, and age. Children with epilepsy were at an increased risk of having 2 vs. 0 Axis I diagnosis: OR=7.72 (95% CI: 2.84 - 21.13) compared to controls. Children with a family history of psychopathology vs. no family history were at higher risk of having 2 vs. 0 Axis I diagnosis: OR=2.60 (95% CI: 1.15 - 5.86). Finally, younger children were at increased risk for 2 vs. 0 Axis I diagnosis: OR=0.86 (95% CI: 0.76 – 0.99). Model 2 was significant indicating that at least one of the predictors in the model is not equal to zero, chi2 (23.46) = 200.21, 12, p < 0.05. There were no significant predictors for 1 vs. 0 Axis I diagnosis. Significant predictors for 2 vs. 0 Axis I diagnoses were epilepsy syndrome and family history of psychopathology. Children with focal epilepsy were at an increased risk for 2 vs. 0 Axis I diagnosis: OR=3.29 (95% CI: 1.06 – 10.21) compared to children with generalized epilepsy. Children with epilepsy who had a family history of psychopathology vs. no family history were at a significantly higher risk of having 2 vs. 0 Axis I diagnoses: OR=2.78 (95% CI: 1.01 – 7.65).Conclusions: Children with epilepsy were at higher risk of having an Axis I disorder overtime compared to controls. Among the children with epilepsy, focal epilepsy and a family history of psychopathology were significant risk factors for an Axis I disorder at both time points.