Risk factors in the development of problems in children with epilepsy : with a particular focus on the family.

Abstract

The main aim of the current study was to examine risk and protective factors associated with the development ofpsychological problems in children with epilepsy. The study aimed to answer the broader question of "Why do some children with epilepsy develop psychological problems while others do not?" A number of risk and protective factors were investigated in children with epilepsy between the ages of 8 - 13 years of age. Three main sets of variables were investigated to determine their association with risk ofpsychological problems in children with epilepsy: 1) family variables ie. family adaptability, family cohesion and family coping 2) illness variables ie. type of seizures, seizure frequency, type of medication, length oftime of diagnosis and 3) demographic variables (including child variables) ie. socio-economic status, number of siblings, age and gender ofthe child with epilepsy. 45 mothers were interviewed and required to complete questionnaires that provided information related to their child's illness, family functioning and demographic factors. In addition, mothers were requested to provide further information related to behavioural and emotional problems that were experiencing with their epileptic child. Broadly the study concluded that a number of risk factors were found to be associated with the development of psychological problems in children with epilepsy. Specifically grandmaI seizures were associated with an increased risk of disorder when compared to petit mal seizures. Higher levels of family adaptability and cohesion were associated with a decreased risk of disorder, and children from families classified as functioning at balanced levels were additionally associated with a lower risk of disorder. Family coping in contrast did not appear to be associated with risk of disorder. The use of poly-medication by children with epilepsy also increased the risk of disorder when compared to those children who used only one type of medication. Children from families falling within the classification of low socioeconomic status were also at an increased risk of disorder as well as those children with epilepsy who came from families where they had a larger number of siblings. The study additionally developed a model of risk and protective factors using logistic regression. It was found that there was a "good fit" of the combined illness variables (type of epilepsy, type of medication), family variables (family type) and demographic variables (SES) with the predicted dependent variable 'risk of disorder'. These results suggest that disease, demographic, family and contextual factors all interacted and overlapped to some extent in predicting the psychological adjustment of epileptic children in the current study.