Depressive symptoms in youth with refractory epilepsy: Exploration of seizure, sociodemographic and cognitive factors

S B. Brothers, Cincinnati Children's Hospital Medical Center, 3333 Burnett Ave, MLC 3015, Cincinnati, OH 45229, United States; University of Cincinnati College of Medicine, CARE/Crawley Building, 3230 Eden Avenue, Suite E-870, Cincinnati, OH 45267, United States. Electronic address: shannon.brothers@cchmc.org.
C Wolfe-Christensen, Cook Children's Medical Center, 901 7(th) Ave, Fort Worth, TX 76104, United States.
H J. Loblein, Children's National Hospital/George Washington University, 111 Michigan Ave NW, Washington DC, 20010, United States.
H Kimbley, Children's Health/Children's Medical Center, Department of Pediatric Neurology, 1935 Medical District Dr., Dallas, TX 75235, United States; Department of Psychology and Psychiatry, University of Texas Southwestern Medical Center, 6363 Forest Park Rd, Dallas, TX 75390, United States.
K E. Patrick, University of Washington/Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA 98105, United States.
L N. Sepeta, Children's National Hospital/George Washington University, 111 Michigan Ave NW, Washington DC, 20010, United States.
K A. McNally, Nationwide Children's Hospital/The Ohio State University, 700 Children's Dr., Columbus, OH 43205, United States.
J I. Koop, Children's Wisconsin/Medical College of Wisconsin, 8915 W. Connell Ct, Milwaukee, WI 53226, United States.
R L. Stilp, Children's Wisconsin/Medical College of Wisconsin, 8915 W. Connell Ct, Milwaukee, WI 53226, United States.
A Ailion, Boston Children's Hospital/Harvard Medical School, 300 Longwood Ave, Boston, MA 02115, United States.
K Boyer, Boston Children's Hospital/Harvard Medical School, 300 Longwood Ave, Boston, MA 02115, United States.
A M. DeCrow, Atrium Health Levine Children's Hospital, Division of Pediatric Psychology and Neuropsychology, 1001 Blythe Blvd Ste 4200, Charlotte, NC 28203, United States.
P Espe-Pfeifer, University of Iowa Hospitals and Clinics, Department of Psychiatry and Pediatrics, 1360 N Dodge St, Iowa City, IA 52245, United States.
C M. Cooper, Cook Children's Medical Center, 901 7(th) Ave, Fort Worth, TX 76104, United States.
M Gabriel, Cook Children's Medical Center, 901 7(th) Ave, Fort Worth, TX 76104, United States.
G M. Berrios-Siervo, Children's Hospital Colorado/University of Colorado School of Medicine, 13123 E 16(th) Ave., Aurora, CO 80045, United States.
P H. Duong, Ann and Robert H. Lurie Children's Hospital of Chicago/Northwestern University Feinberg School of Medicine, 225 E Chicago Ave, Chicago, IL 60611, United States.
E Hodges, Department of Psychiatry, University of Michigan, 1500 E. Medical Center Dr., Ann Arbor, MI 48109, United States.
D F. Marshall, Department of Psychiatry, University of Michigan, 1500 E. Medical Center Dr., Ann Arbor, MI 48109, United States.
G Gaston, The Medical University of South Carolina, 99 Jonathan Lucas Street, MSC 160, Charleston, SC 29425, United States.
M M. Berl, Children's National Hospital/George Washington University, 111 Michigan Ave NW, Washington DC, 20010, United States.
J L. Wagner, The Medical University of South Carolina, 99 Jonathan Lucas Street, MSC 160, Charleston, SC 29425, United States.

Document Type

Journal Article

Publication Date

7-30-2025

Journal

Epilepsy & behavior : E&B

Volume

171

DOI

10.1016/j.yebeh.2025.110608

Keywords

Depression; Epilepsy; IQ; Pediatric; Pre-Surgical

Abstract

INTRODUCTION: Rates of depressive symptoms in children and youth with epilepsy (CYE) vary among studies, ranging from 12 to 41%. The current study examined depressive symptoms in a large, multi-site sample of CYE who completed measures of emotional and behavioral functioning as part of a pre-surgical neuropsychological evaluation. METHODS: CYE ranged in age from 5 to 18 years old, had refractory epilepsy (n = 416), and underwent neuropsychological assessment, including standardized assessment of intellectual (IQ), emotional, and behavioral functioning using caregiver-proxy. Sociodemographic (e.g., age, biological sex, race/ethnicity, insurance status, distance from hospital) and epilepsy-specific characteristics e.g., seizure type, epilepsy duration, frequency, foci, number of anti-seizure medications [ASM], and MRI findings) were also examined. RESULTS: Elevated levels (i.e., at-risk or clinically significant threshold) of depressive symptoms were reported in 28.9 % of CYE. Youth with temporal lobe epilepsy (TLE; 18.9 %) had significantly higher rates of depressive symptoms compared to youth with extratemporal epilepsy (11.7 %; OR = 1.73, 95 % CI [1.10, 2.73]; χ (2) = 7.08, p = 0.029). All other sociodemographic and epilepsy-specific variables were unrelated to levels of depressive symptoms. There was no difference in level of depressive symptoms for CYE with IQ below 70 despite being more likely to be in a minority racial/ethnic group, having public insurance, and experiencing more frequent seizures. CONCLUSIONS: CYE are at risk of comorbid depressive symptoms, especially if they have TLE. However, other seizure and sociodemographic variables did not increase risk or resilience. Depression screening during routine epilepsy care is indicated, including for those CYE with low IQ.

Department

Psychiatry and Behavioral Sciences

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