Childhood epilepsy and asthma: changes in behavior problems related to gender and change in condition severity.

Abstract

We conducted a 4-year follow-up study of behavior problems in children with either epilepsy (n = 115) or asthma (n = 105) to identify changes in behavior problems as they were related to gender and change in condition severity. All children were between ages 8 and 13 years and had been diagnosed with their respective conditions for >/=1 year at entry into the study. Behavior problems were measured by using the mother's rating on the Child Behavior Checklist. Baseline and follow-up behavior problem scores were examined to see if significant changes occurred over the observation period of the study. To explore change in behavior based on condition severity, each child was placed into "low" and "high" condition severity groups at each time, resulting in four groups: low/low, low/high, high/low, or high/high. There were too few cases in the low/high group to be included in some analyses. Data were analyzed by using analysis of covariance with adjustment for baseline behaviors, age, and age of onset. Within both samples, there was a significant improvement over time for the Total Behavior Problems and Internalizing Problems scores (p </= 0.006). Improvement in Internalizing Problems was greater for the asthma sample than for the epilepsy sample (p </= 0.007). Within the epilepsy sample, there was a significant gender-by-change in seizure condition interaction for Total Behavior Problems, Internalizing Problems, and Externalizing Problems. The interaction effect indicated that behavior problems in girls with high seizure severity at both baseline and follow-up became substantially worse over the 4-year period. It was concluded that adolescent girls, particularly those with high-severity epilepsy during the transition to adolescence, merit closer clinical supervision for behavior problems.