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(Pediatrics in Review. 2008;29:e9-e14.)
© 2008 American Academy of Pediatrics

Psychiatric Disorders in Children and Adolescents Who Have Epilepsy

Jana E. Jones, PhD^*
Joan K. Austin, DNS, RN
Rochelle Caplan, MD
David Dunn, MD
Sigita Plioplys, MD^**
Jay A. Salpekar, MD^¶

^* Assistant Professor, Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, Wisc
Distinguished Professor of Nursing, Indiana University School of Nursing, Indianapolis, Ind
Professor, Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Calif
Arthur B. Richter Professor of Child Psychiatry, Indiana University, Indianapolis, Ind
^** Assistant Professor, Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Ill
^¶ Assistant Professor of Psychiatry and Pediatrics, George Washington University School of Medicine, Washington, DC

The first 300 words of the full text of this article appear below.

	Introduction

 
Epilepsy occurs in approximately 1% of the population. It is the third most common neurologic disorder in the United States after Alzheimer disease and stroke. The prevalence of epilepsy is equal to the combined prevalence of cerebral palsy, multiple sclerosis, and Parkinson disease. Epilepsy is the most common childhood neurologic disorder, affecting 0.5% to 1.0% of children younger than age 16 years. (1) More than 326,000 children younger than age 15 years have epilepsy, and approximately 90,000 have seizures that are not controlled completely by treatment. Epilepsy often occurs in conjunction with other conditions, including autism spectrum disorder, cerebral palsy, Down syndrome, and intellectual disability.

Although seizures are the most readily identifiable feature of epilepsy, behavior and cognitive functioning also are affected negatively in a substantial number of children. The prevalence of psychiatric comorbidity in epilepsy is significantly higher than in healthy controls or in children who have other chronic health conditions. This article reviews the current knowledge of coexisting psychiatric disorders in children who have epilepsy and discusses diagnostic and treatment issues.

	Epidemiology

 
Two epidemiologic investigations, conducted in the United Kingdom 3 decades apart, demonstrate that psychiatric comorbidity is overrepresented in pediatric epilepsy. In the classic Isle of Wight study, Rutter and associates (2) reported that 7% of children in the general population exhibited a mental health problem compared with 12% of children who had non-neurologic physical disorders. Significantly higher rates were reported in those having epilepsy, including 29% in children who had uncomplicated (idiopathic and cryptogenic) epilepsy and 58% in those who had complicated epilepsy (seizures in the context of structural central nervous system abnormalities). Strikingly similar findings were reported in a recent United Kingdom epidemiologic investigation by Davies and colleagues. (3) Among children ages 5 to 15 years of age, psychiatric disorders . . . [Full Text of this Article]