Abstracts

Children with epilepsy are at a greater risk for psychosocial difficulties compared to those with other chronic illnesses. Rates of psychopathology range from 21-60%, with anxiety disorders most prevalent (Caplan, et al, 2005 [italic]Epilepsia[/italic], 46, 720-30). Underlying central nervous system (CNS) disturbances, social, academic, family [amp] psychological stressors lead to poor quality of life. It is imperative health care practitioners utilize a multidisciplinary approach in treatment because seizure cessation alone will not improve quality of life., 2117 children were seen for a primary diagnosis of epilepsy in a pediatric epilepsy clinic (PEC) over 18 months. 4% were referred to a pediatric psychologist who provided services within the PEC. Behavioral consultation sessions occurred in conjunction with a medical visit or were scheduled at an alternative time. Interventions were tailored to the children and their families, including evidence-based components of behavior management, cognitive-behavioral techniques for depression, anxiety, [amp] coping skills enhancement., The ages of the 84 (41 girls; 43 boys) children ranged from 1-21 years. The most common diagnosis was complex partial epilepsy. 19% had developmental diagnoses already established, 14% behavioral/emotional diagnoses, [amp] 1.7% both developmental [amp] behavioral/emotional diagnoses. The primary referral problem for 38% was disruptive behaviors, with higher rates for boys (49%) compared to girls (27%). However, girls were more likely to be referred for child/family adjustment to seizures (37%) compared to boys (21%). 11 were already receiving some form of psychological/psychiatric care. 12 were not seen by the psychologist. At least one behavioral consultation was provided to 72 children. These consultations ranged from 1-14 visits. 22% received brief cognitive-behavioral intervention for internalizing symptoms, [amp] 17% received behavior management for externalizing behaviors. The remaining patients did not return for follow-up, were referred for specialized care, or did not require further services., Fewer children were referred than published prevalence rates indicate for psychiatric co-morbidities in children with epilepsy (Ott, et al 2003 [italic]Epilepsia[/italic], 44, 591-597). Having a psychologist on staff in the clinic may provide ease of access to [sub][amp][/sub] increase participation in mental health services while decreasing mental health stigma (Living Well With Epilepsy, 2003). Results of this study indicate healthcare practitioners have only started the journey in providing comprehensive care to youth with epilepsy. This study suggests it is feasible and critical for a psychologist to provide standardized services in a PEC. Indeed, future studies should examine evidence-based interventions tailored to youth with epilepsy (Wagner [amp] Smith, 2006 [italic]Epilepsy Beh[/italic], 8, 39-49.),