Mood and behavior disorder in pediatric epilepsy

Abstract

Pediatric epilepsy is frequently associated with psychiatric comorbidities such as mood, anxiety, psychosis, attention-deficit/hyperactivity disorder and disruptive behavior disorder. The incidence of suicide is also higher in this population. Psychiatric conditions were traditionally considered to be a consequence of the seizure disorder; however, more recent advances in the field suggest a bidirectional relationship. Thus, the existence of psychiatric disorders may increase the likelihood of developing a seizure disorder, while the presence of chronic epilepsy and the use of antiepileptic drugs can increase the incidence of comorbid psychiatric disorders and impact the quality of life for affected patients. In this review, internalizing (depression, anxiety and suicide) and, externalizing (attention-deficit/hyperactivity disorder, oppositional defiant disorder and conduct disorder) disorders, and psychosis in pediatric epilepsy are discussed. The role of evidence-based psychosocial and psychopharmacological interventions for these mood and behavior disorders, in addition to the validity of neuropsychological testing to assist identification of these combined conditions in pediatric epilepsy are also reviewed.