Prevalence of psychopathology in childhood epilepsy: categorical and dimensional measures

Few studies have utilized both categorical and dimensional measures of psychopathology in children with epilepsy. We evaluated 173 children (88 males, 85 females; mean age 11.7y [SD 1.8]; range 9-14y) who had epilepsy (generalized 36%, partial 61%) for at least 6 months. The primary caregiver completed a dimensional measure, the Child Behavior Checklist (CBCL), and a categorical measure, either the Child Symptom Inventory (CSI) or the Adolescent Symptom Inventory (ASI). Correlation coefficients were computed between the CBCL scores and CSI/ASI symptom scores. For all children, diagnostic risk was higher than norms on CSI/ASI for attention-deficit-hyperactivity disorder (ADHD) inattentive type, ADHD combined type, oppositional defiant disorder, and dysthymic disorder. For children between 9 and 12 years, elevated scores were found on CBCL, total, internalizing, and attention problems, and on CSI, diagnostic risk for conduct disorder and Asperger syndrome. For children of 13 and 14 years, ASI diagnostic risk was higher for specific phobia, obsessions, posttraumatic stress disorder, motor tics, antisocial personality, panic attack, somatization disorder, and enuresis. CBCL and symptom scores on the CSI/ASI were significantly correlated. The conclusion was that children with epilepsy have high rates of behavioral difficulties on both dimensional and categorical measures. Concurrent validity for the CSI/ASI was supported.