Autism, ADHD and parent-reported behavioural difficulties in young children with epilepsy
Autism, ADHD and parent-reported behavioural difficulties in young children with epilepsy
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DOI：
10.1016/j.seizure.2019.08.003
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发表时间：
2019-10-01
影响因子：
3
通讯作者：
Scott, Rod C.
中科院分区：
文献类型：
--
作者：
Reilly, Colin;Atkinson, Patricia;Scott, Rod C.
目的：提供自闭症谱系障碍（ASD）、注意力缺陷/多动障碍（ADHD）和父母报告的幼儿癫痫行为困难的患病率数据，并将结果与无癫痫的神经残疾（神经发育/神经障碍）儿童进行比较。方法：对性别、实足年龄和发育年龄相匹配的癫痫患儿（1 ~ 7岁，n = 48）和神经功能障碍患儿（1 ~ 7岁，n = 48）进行心理评估。家长完成了包括优势和困难问卷（SDQ）在内的行为测量。DSM-5对ASD和ADHD的诊断是在共识病例会议上做出的。使用线性回归分析与儿童行为相关的因素。结果：癫痫患儿中符合ASD标准的占18%，符合ADHD标准的占40%（非癫痫组相应数据分别为41%和27%）。两组中有很大比例（76%-78%）的人在SDQ的风险范围内得分，并且经常在多个行为领域遇到困难。癫痫患儿对注意力和情绪表达了更多的担忧。没有癫痫因素与行为测量得分显著相关。意义：幼儿癫痫患儿的父母报告的行为困难水平非常高，ADHD和ASD的风险很高，这突出了综合多学科评估的必要性。除了注意力和情绪外，行为方面的担忧并不比其他非癫痫相关神经障碍的儿童更大。癫痫相关因素与儿童行为无关，这表明癫痫发作本身并不会带来行为困难的独特风险。
Purpose: To provide data on the prevalence of Autism Spectrum Disorder (ASD), Attention-Deficit/Hyperactivity Disorder (ADHD), and parent reported behaviour difficulties in young children with epilepsy, and to compare results with children with neurodisability (neurodevelopmental/neurological difficulties) without epilepsy.Method: Children with epilepsy (1-7 years, n = 48) and children with neurodisability (1-7 years, n = 48) matched for gender, chronological and developmental age underwent psychological assessment. Parents completed measures of behaviour including the Strengths and Difficulties Questionnaire (SDQ). DSM-5 diagnoses of ASD and ADHD were made at consensus case conferences. Factors associated with child behaviour were analysed using linear regression.Results: Of the children with epilepsy, 18% met ASD criteria and 40% met ADHD criteria (corresponding figures in the non-epilepsy group were 41% and 27%). A large proportion (76%-78%) in both groups scored in the atrisk range on the SDQ and frequently had difficulties across multiple behavioural domains. Children with epilepsy had more concerns expressed regarding attention and mood. None of the epilepsy factors were significantly associated with scores on the behavioural measures.Significance: Young children with epilepsy had a very high level of parent reported behavioural difficulties and a high risk for ADHD and ASD highlighting the need for comprehensive multidisciplinary assessment. Behavioural concerns were not greater than for other children with non-epilepsy related neurodisability with the exception of attention and mood. Epilepsy related factors were not associated with child behaviour, suggesting that seizures per se do not confer a unique risk for behavioural difficulties.