Behavioral assessment of Japanese children with epilepsy using SDQ (strengths and difficulties questionnaire)

Abstract

The aim of this study was to elucidate the availability of the strengths and difficulties questionnaire (SDQ) as a screening tool for identifying behavioral problems in Japanese children with epilepsy. Methods: Eighty-three 4–16year-old epileptic patients, followed at Tanabe-Kadobayashi Children’s Clinic, were studied. Children with severe mental or physical disability were excluded. The Japanese version of the SDQ was used, and scores were compared to the Japanese standard. Results: ‘Hyperactivity’ was the SDQ category with the most striking differences from normal: a significant numbers of children had scores above the clinically normal range and only a small proportion were within the normal range (p<0.0001). The rates of epilepsy patients with scores above normal range were also significantly higher for ‘peer problems’ and ‘conduct problems’ (p<0.0001 and p<0.01). The rates of epilepsy patients with scores within the normal range was significantly lower for ‘emotional symptoms’ than in normal controls (p<0.001). On the other hand, the ‘pro-social behavior’ score did not differ significantly from the Japanese standard. As for clinical factors, patients with symptomatic localization-related epilepsy and focal electroencephalographic abnormalities had significantly higher scores for some SDQ items. Age at epilepsy onset correlated negatively with scores for ‘total difficulties’ and ‘hyperactivity’, suggesting early onset to be a risk factor for poor SDQ scores. Conclusions: These findings confirm that higher rates of psychiatric comorbidity in Japanese children with epilepsy may be diagnosed using SDQ in Japanese children with epilepsy. These problems should be addressed in the early phase of epilepsy management in order to preserve health-related quality of life for affected patients.