Abstract
ObjectivesTo assess symptoms of post-traumatic stress disorder (PTSD) in children with severe epilepsy and the associations of trauma symptoms across age, comorbid symptoms, epilepsy-specific factors, parental resources, and psychopathology. MethodsFifty children with severe epilepsy across three different age groups (0–5 yrs., 6–12 yrs., 13–18 yrs.) were assessed with developmental-sensitive and standardized PTSD assessment tools when hospitalized at the tertiary epilepsy center Filadelfia, Denmark. The Diagnostic Infant and Preschool Assessment (DIPA), the Darryl test, and the ITQ questionnaire were used to assess the three age groups, respectively. ResultsTwenty-two percent of the overall sample met the criteria for PTSD, with a prevalence of symptoms increasing with age (6%, 28%, and 40%). Comorbid psychiatric symptoms in preschoolers were present in 81% of the children witnessing a high level of distress in this group. Behavioral difficulties were elevated across all three age groups, and 40% of the children with trauma symptoms had a parent with concurrent psychopathology. ConclusionTo the authors’ knowledge, this study is the first to assess trauma symptoms with standardized tests in children with more complicated epilepsies. Trauma symptoms in the group are high; however, there is a need for larger scale studies and research into trauma symptoms in children with more severe epilepsy than those assessable with the included assessment tools. The trauma perspective in severe childhood epilepsy might further clarify the complex associations of biological and contextual variables that affect the children’s life quality and enable better preventative treatment options for this group.
Highlights
Childhood-onset epilepsy is associated with psychiatric and medical comorbidity [1,2,3,4,5,6,7] and cognitive, behavioral, and psychosocial difficulties [8,9,10,11]
We found a high number of post-traumatic stress disorder (PTSD) symptoms and subclinical symptoms in schoolchildren and adolescents
Despite a lower level of PTSD symptoms in the preschoolers, we found comorbid psychiatric symptoms in 81% of the children witnessing a high level of distress in this group
Summary
Childhood-onset epilepsy is associated with psychiatric and medical comorbidity [1,2,3,4,5,6,7] and cognitive, behavioral, and psychosocial difficulties [8,9,10,11]. Scandinavian nationwide cohort studies have demonstrated that up to 80% of children with epilepsy have one or more comorbid disorders [12] and have elevated risks of developing psychiatric disorders in later life [13]. The comorbidity of childhood epilepsy seems to be a superior predictor of impacted life quality [15,16] compared to illness-specific factors. ⇑ Corresponding author at: The Danish Epilepsy Center, Filadelfia, Kolonivej 1, Increasing awareness of the factors beyond biological causes of comorbidity and life quality in children has emerged over the past two decades. Studies have demonstrated the influence of family factors [17,18] and the social context [19,20] on the development of child psychopathology and point to a contextual understanding of impacted life quality in children with epilepsy [21]. We further know that family resources are highly compromised by concerning levels of parental stress and psychopathology in caregivers of children with epilepsy [26,27,28,29,30,31]
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