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Pastorino GMG, Olivieri M, Viggiano A, Meccariello R, Roccella M, Parisi L, Cerulli Irelli E, Di Bonaventura C, Orsini A, Operto FF. Depressive symptoms in children and adolescents with epilepsy and primary headache: a cross-sectional observational study. Front Neurol 2024; 15:1395003. [PMID: 38984036 PMCID: PMC11231184 DOI: 10.3389/fneur.2024.1395003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 06/03/2024] [Indexed: 07/11/2024] Open
Abstract
Background The primary aims of our cross-sectional observational study were: (i) to determine the prevalence of depressive symptoms in children and adolescents with epilepsy compared to controls and (ii) to explore the difference in depressive symptoms in patients with epilepsy only and those with epilepsy and primary headache as a comorbidity. The secondary objective was to explore parental stress levels. Methods 68 pediatric patients aged 6-18 years (44 with epilepsy only and 24 with epilepsy and headache) and 50 controls were recruited. Depressive profile and parental stress were assessed using Children's Depression Inventory, Second Edition (CDI-2) and Parenting Stress Index-Short Form (PSI-SF). Results The group with epilepsy showed significantly high depressive symptoms and parental stress compared to controls. The patients with headache in comorbidity experienced more depressive symptoms than those with epilepsy only. Conclusion Depressive symptoms are more prevalent in patients who have comorbid epilepsy and primary headache; therefore, the neurological/psychological mechanisms underlying this condition should be further investigated. The simultaneous presence of epilepsy, headache and depressive symptoms impacts the quality of life of patients and their parents, increasing parental stress and family management.
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Affiliation(s)
- Grazia Maria Giovanna Pastorino
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno, Italy
| | - Miriam Olivieri
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno, Italy
| | - Andrea Viggiano
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy
| | - Rosaria Meccariello
- Department of Movement and Well-Being Sciences, Parthenope University of Naples, Naples, Italy
| | - Michele Roccella
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Lucia Parisi
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | | | | | - Alessandro Orsini
- Pediatric Neurology, Azienda Ospedaliero-Universitaria Pisana, Pisa University Hospital, Pisa, Italy
| | - Francesca F. Operto
- Department of Science of Health, School of Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy
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Baumer NT, Hojlo MA, Pawlowski KG, Milliken AL, Lombardo AM, Sargado S, Soccorso C, Davidson EJ, Barbaresi WJ. Co-occurring conditions in Down syndrome: Findings from a clinical database. AMERICAN JOURNAL OF MEDICAL GENETICS. PART C, SEMINARS IN MEDICAL GENETICS 2023; 193:e32072. [PMID: 37873945 DOI: 10.1002/ajmg.c.32072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/03/2023] [Accepted: 10/06/2023] [Indexed: 10/25/2023]
Abstract
Individuals with Down syndrome (DS) experience a range of medical and neurodevelopmental conditions, necessitating systematic study of their occurrence and impact on neurodevelopmental outcomes. We describe the prevalence and relationships of medical, neurodevelopmental (ND), and mental health (MH) conditions in children with DS. We created a prospective clinical database of individuals with DS, integrated into the workflow of a specialty Down Syndrome Program at a specialty pediatric referral hospital. Conditions were collected through caregiver- and clinician report at clinical visits (N = 599). We calculated frequencies of medical, ND, and MH conditions and then assessed the relationship between medical, ND, and MH conditions using frequencies and comparative statistics. The most frequent co-occurring conditions were vision (72.5%), ear/hearing (71.0%), gastrointestinal (61.3%), respiratory (45.6%), and feeding (33.6%) problems, with variation in frequency by age. ND and MH conditions were reported in one quarter, most commonly autism spectrum disorder and attention-deficit/hyperactivity disorder. Those with ND and MH conditions had greater frequency of medical conditions, with highest rates of vision, ear/hearing, and gastrointestinal issues, and CHD. Systematically collected clinical data in a large cohort of children with DS reveals high prevalence of several co-occurring medical, ND, and MH conditions. Clinical care requires an understanding of the complex relationship between medical conditions and neurodevelopment.
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Affiliation(s)
- Nicole T Baumer
- Division of Developmental Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Neurology, Boston Children's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Margaret A Hojlo
- Division of Developmental Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Katherine G Pawlowski
- Division of Developmental Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Anna L Milliken
- Division of Developmental Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Angela M Lombardo
- Division of Developmental Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Sabrina Sargado
- Division of Developmental Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Cara Soccorso
- Division of Developmental Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Emily J Davidson
- Division of Developmental Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
| | - William J Barbaresi
- Division of Developmental Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
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Gruescu ACS, Popoiu C, Levai MC, Burtic SR, Sanda II, Neda-Stepan O, Rosca O, Fericean RM, Dumitru C, Stelea L. Stress Dynamics in Families with Children with Neuropsychiatric Disorders during the COVID-19 Pandemic: A Three-Year Longitudinal Assessment. J Clin Med 2023; 12:7170. [PMID: 38002782 PMCID: PMC10672643 DOI: 10.3390/jcm12227170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/14/2023] [Accepted: 11/17/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND AND OBJECTIVES This study explores the impact of the COVID-19 pandemic on families with children diagnosed with neuropsychiatric disorders, focusing on stress dynamics and quality of life. MATERIALS AND METHODS A longitudinal survey was conducted over three years (2020-2022) involving 168 families. The survey included data on demographics, diagnosed conditions, access to therapies, mental well-being, and perceived challenges. RESULTS The study involved 62, 51, and 55 families in 2020, 2021, and 2022, respectively. ADHD emerged as the most prevalent condition, diagnosed in approximately 32% of the children. The pandemic significantly affected therapy access, with parents reporting a decrease from an average score of 8.1 in 2020 to 6.5 in 2022 (p = 0.029). Parents also reported increased feelings of being overwhelmed, peaking at 8.0 in 2021 before declining to 6.3 in 2022 (p = 0.017). Despite these challenges, there was a positive trend in family mental well-being, with scores increasing from 5.1 in 2020 to 6.7 in 2022 (p = 0.031). The Parental Stress Index (PSI) indicated decreasing trends in Emotional Stress and Parent-Child Communication Difficulties (p < 0.001), and Behavioral Challenges in children showed a significant reduction across the years (p < 0.001). The Hospital Anxiety and Depression Scale (HADS) reflected a moderate reduction in anxiety levels from 7.6 in 2020 to 6.0 in 2022 (p = 0.038), although depression scores did not show a significant change. CONCLUSIONS The COVID-19 pandemic introduced notable challenges for families with neuropsychiatrically diagnosed children, particularly in therapy access and increased parental stress. However, the study also reveals a general improvement in family dynamics, mental well-being, and a decrease in behavioral challenges over time. The necessity of this study stems from the critical need to examine the impact of the COVID-19 pandemic on families with neuropsychiatrically diagnosed children, focusing on their resilience and adaptation in navigating therapy access, parental stress, and overall mental well-being.
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Affiliation(s)
- Ada Claudia Silvana Gruescu
- Department of Pediatrics, Victor Babes University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (A.C.S.G.); (C.P.)
- Doctoral School, Victor Babes University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (S.R.B.); (I.I.S.); (O.N.-S.); (R.M.F.)
| | - Calin Popoiu
- Department of Pediatrics, Victor Babes University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (A.C.S.G.); (C.P.)
| | - Mihaela Codrina Levai
- Research Center for Medical Communication, Victor Babes University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Sonia Roxana Burtic
- Doctoral School, Victor Babes University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (S.R.B.); (I.I.S.); (O.N.-S.); (R.M.F.)
- Research Center for Medical Communication, Victor Babes University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Isabella Ionela Sanda
- Doctoral School, Victor Babes University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (S.R.B.); (I.I.S.); (O.N.-S.); (R.M.F.)
| | - Oana Neda-Stepan
- Doctoral School, Victor Babes University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (S.R.B.); (I.I.S.); (O.N.-S.); (R.M.F.)
- Department VIII—Neurosciences, Discipline of Psychiatry, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Ovidiu Rosca
- Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Roxana Manuela Fericean
- Doctoral School, Victor Babes University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (S.R.B.); (I.I.S.); (O.N.-S.); (R.M.F.)
- Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Catalin Dumitru
- Department of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (C.D.); (L.S.)
| | - Lavinia Stelea
- Department of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (C.D.); (L.S.)
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Wu Y, Zhang R, Tang J, Li X, Wang Y, Li T, Wu F, Dou X, Wang D, Jiang L. Multi-dimensional influence of pediatric epilepsy on children and their families: A cross-sectional study. Epilepsy Behav 2023; 146:109360. [PMID: 37499581 DOI: 10.1016/j.yebeh.2023.109360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 07/11/2023] [Accepted: 07/13/2023] [Indexed: 07/29/2023]
Abstract
OBJECTIVE In this study, we aimed to evaluate the effects of pediatric epilepsy on family burden, parental anxiety, depression states, and quality of life of both parents and children. METHODS The study was undertaken between March and December 2021 using an online questionnaire that included the Family Burden Scale of Disease, the 7-item Generalized Anxiety Disorder scale, the 9-item Patient Health Questionnaire, the WHO Quality of Life Scale (WHOQOL-BREF), and the PedsQL 4.0 Generic Core Scales (parent-proxy report). RESULTS A total of 288 parents of children aged 2-18 years were included. Overall, 94.8% of the participating families experienced high levels of disease burden, 67.0% of parents suffered from anxiety states, 57.0% suffered from depression states, and 56.2% of children with epilepsy suffered from comorbid neuropsychiatric symptoms. The mean WHOQOL-BREF score for parental quality of life was 53.7 ± 12.8, while the median PedsQL score for children's quality of life was 65.4 (49.6-81.7). Parental depression states contributed the most to family burden and parental quality of life, whereas comorbidities of epilepsy contributed the most to children's quality of life. Seizure frequency significantly influenced parental anxiety states, and family burden was the most significant predictor of parental depression states. CONCLUSION Heavy disease burden, anxiety states, and depression states are prevalent in families with children suffering from epilepsy, and most have a poor quality of life. There is a need for greater focus on the quality of life of this patient population and their caregivers, as well as increased resources to help combat anxiety, depression, and poor quality of life.
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Affiliation(s)
- You Wu
- Department of Neurology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China; Department of Neurology, Xi'an Children's Hospital, the Affiliated Children's Hospital of Xi'an Jiaotong University, Shannxi, China
| | - Rui Zhang
- Department of Neurology, Xi'an Children's Hospital, the Affiliated Children's Hospital of Xi'an Jiaotong University, Shannxi, China
| | - Jianyong Tang
- Department of Laboratory Medicine, Xi'an Children's Hospital, the Affiliated Children's Hospital of Xi'an Jiaotong University, Shaanxi, China
| | - Xia Li
- Department of Neurology, Xi'an Children's Hospital, the Affiliated Children's Hospital of Xi'an Jiaotong University, Shannxi, China
| | - Yan Wang
- Department of Neurology, Xi'an Children's Hospital, the Affiliated Children's Hospital of Xi'an Jiaotong University, Shannxi, China
| | - Taoli Li
- Department of Neurology, Xi'an Children's Hospital, the Affiliated Children's Hospital of Xi'an Jiaotong University, Shannxi, China
| | - Fang Wu
- Department of Neurology, Xi'an Children's Hospital, the Affiliated Children's Hospital of Xi'an Jiaotong University, Shannxi, China
| | - Xiangjun Dou
- Department of Neurology, Xi'an Children's Hospital, the Affiliated Children's Hospital of Xi'an Jiaotong University, Shannxi, China
| | - Dong Wang
- Department of Neurology, Xi'an Children's Hospital, the Affiliated Children's Hospital of Xi'an Jiaotong University, Shannxi, China.
| | - Li Jiang
- Department of Neurology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China.
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Seid J, Gebrehiwot B, Andualem F, Kassaye A, Mohammed J, Akele M. Factors associated with stress-related symptoms among people with epilepsy in Ethiopia, a cross-sectional study. Front Neurol 2023; 14:1218448. [PMID: 37583951 PMCID: PMC10425181 DOI: 10.3389/fneur.2023.1218448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 07/14/2023] [Indexed: 08/17/2023] Open
Abstract
Introduction Stress is a common psychological problem present in people with epilepsy and has a serious impact on the health-related satisfaction of people with epilepsy and their cohabiters. This study aimed to assess the magnitude and related factors of stress. Methods A hospital-based cross-sectional study was carried out among 301 systematically chosen people with epilepsy. The seven stress-related items of the Depression, Anxiety, and Stress -21 questionnaire was used to measure stress. Data were entered using Epi Info and analyzed by SPSS version 25. Predictors with a p-value < 0.20 in the bivariate logistic regression were transferred into the multivariate model. A p-value of less than 0.05 was viewed as statistically significant. Result The prevalence of stress symptoms in this study was 23.9%. Daily labor occupational status with Adjusted Odds ratio [(AOR) = 0.042, 95% CI: 0.004, 0.469], onset of illness at the age of 18 years and above (AOR = 0.188, 95% CI: 0.046, 0.771), perceived stigma (AOR = 3.320, 95% CI: 1.345, 8.200), the presence of anxiety symptoms (AOR = 8.275, 95% CI: 3.345, 20.471), and belief that the condition is untreatable (AOR = 6.360, 95% CI: 1.647, 24.562) were significantly associated factors. Conclusion The occurrence of stress was high, and it reinforced that there is a requisite for the identification and handling of stress-related symptoms among people with epilepsy.
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Affiliation(s)
- Jemal Seid
- Department of Psychiatric Nursing, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Birhane Gebrehiwot
- Department of Psychiatric Nursing, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Fantahun Andualem
- Department of Psychiatric Nursing, College of Health Sciences, Adigrat University, Adigrat, Ethiopia
| | - Abenet Kassaye
- Department of Psychiatric Nursing, College of Health Sciences, Adigrat University, Adigrat, Ethiopia
| | - Jemal Mohammed
- Department of Medicine, Dessie Comprehensive Specialized Hospital, Dessie, Ethiopia
| | - Mulugeta Akele
- Department of Psychiatry, College of Medicine and Health Science, Mizan-Tepi University, Mizan, Ethiopia
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Lahmini W, Gyamfi SO, Bourrous M. Survey on the management of childhood epilepsy among general practitioners in the area of Marrakech. BMC Pediatr 2023; 23:159. [PMID: 37016344 PMCID: PMC10071602 DOI: 10.1186/s12887-023-03947-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 10/04/2022] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND Epilepsy is a common chronic neurological disorder in the pediatric population and its evolution can be fatal. It represents a major public health problem as well as an economic burden for the families of affected children, health systems and the overall economies of countries. This further accentuates the role that general practitioners can play in the management of childhood epilepsy in the face of the persistent lack of neurologists and neuro-pediatricians in our country. METHODS In order to assess the knowledge and therapeutic habits of general practitioners, we carried out a descriptive and cross-sectional study with general practitioners practicing in the two healthcare sectors: public and private, and in two settings: urban and rural, during the year 2018. The data was collected through a pre-established survey. RESULTS In total, 155 general practitioners responded to the survey. For 85.2% of physicians, the diagnosis of childhood epilepsy was based on interrogation, physical examination, and EEG. While brain imaging would be systematic regardless of the type of epilepsy for 45.2% of doctors. Only 6 doctors (3.9%) had knowledge of the latest classifications of the "ILAE". For treatment, the majority of physicians (65.5%) adopted first-line monotherapy with valproate in leading position. Almost half of the doctors (48.4%) found that education of parents and children was always necessary. None of the GPs interviewed in our series assessed the academic impact of epilepsy. Only 32% of doctors had received continuing education on epilepsy. CONCLUSION The data from our study demonstrates that continuing education on the management of childhood epilepsy and the greater involvement of general practitioners were essential elements in improving care.
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Affiliation(s)
- Widad Lahmini
- Department of Paediatric Emergency, Mohamed VI UHC, Cadi Ayyad University, Faculty of Medicine and Pharmacy, PO Box: 7010, Sidi Abbad Street, 40000, Marrakech, Morocco
| | - Samuel Opoku Gyamfi
- Department of Paediatric Emergency, Mohamed VI UHC, Cadi Ayyad University, Faculty of Medicine and Pharmacy, PO Box: 7010, Sidi Abbad Street, 40000, Marrakech, Morocco
| | - Mounir Bourrous
- Department of Paediatric Emergency, Mohamed VI UHC, Cadi Ayyad University, Faculty of Medicine and Pharmacy, PO Box: 7010, Sidi Abbad Street, 40000, Marrakech, Morocco.
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Chiang JA, Tran T, Swami S, Shin E, Nussbaum N, DeLeon R, Hermann BP, Clarke D, Schraegle WA. Neighborhood disadvantage and health-related quality of life in pediatric epilepsy. Epilepsy Behav 2023; 142:109171. [PMID: 36989568 DOI: 10.1016/j.yebeh.2023.109171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 03/04/2023] [Accepted: 03/05/2023] [Indexed: 03/31/2023]
Abstract
INTRODUCTION While several demographic and epilepsy-specific characteristics are associated with diminished HRQoL in children and adolescents with epilepsy, prior investigations have failed to incorporate and address the influence of broader social contextual factors on functional outcomes. To address this gap, the purpose of the current study was to investigate the role of neighborhood disadvantage on HRQoL, including the extent to which familial and seizure-specific risk factors are impacted. METHODS Data included parental ratings on the Quality of Life in Childhood Epilepsy (QOLCE) questionnaire for 135 children and adolescents with epilepsy, and the Area Deprivation Index (ADI) to measure neighborhood disadvantage. Bivariate correlations were conducted to identify significant associations with neighborhood disadvantage, followed by a three-stage hierarchical multiple regression to predict HRQoL. Follow-up binary logistic regressions were used to determine the risk conferred by neighborhood disadvantage on sociodemographic, seizure-specific, and HRQoL factors. RESULTS Moderate associations between neighborhood disadvantage and familial factors, including parental psychiatric history and Medicaid insurance, were identified, while disadvantage and greater seizure frequency were marginally associated. Neighborhood disadvantage independently predicted HRQoL, and was the sole significant predictor of HRQoL when familial factors were incorporated. Children with epilepsy living in disadvantaged areas were four times more likely to have diminished HRQoL, five times more likely to live with a parent with a significant psychiatric history, and four times more likely to reside with a family receiving Medicaid insurance. CONCLUSIONS These results highlight the importance of identifying high-risk groups, as the cumulative burden of social context, familial factors, and seizure-specific characteristics contribute to lower HRQoL in pediatric epilepsy which disproportionately affects patients from lower-resourced backgrounds. Potentially modifiable factors such as parental psychiatric status exist within the child's environment, emphasizing the importance of a whole-child approach to patient care. Further exploration of disadvantage in this population is needed to better understand these relationships over time.
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Affiliation(s)
- Jenna A Chiang
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, TX, USA
| | - Thomas Tran
- Comprehensive Pediatric Epilepsy Center, Dell Children's Medical Center, Austin, TX, USA
| | - Sonya Swami
- Comprehensive Pediatric Epilepsy Center, Dell Children's Medical Center, Austin, TX, USA
| | - Elice Shin
- Comprehensive Pediatric Epilepsy Center, Dell Children's Medical Center, Austin, TX, USA
| | - Nancy Nussbaum
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, TX, USA; Comprehensive Pediatric Epilepsy Center, Dell Children's Medical Center, Austin, TX, USA
| | - Rosario DeLeon
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, TX, USA; Comprehensive Pediatric Epilepsy Center, Dell Children's Medical Center, Austin, TX, USA; Department of Pediatrics, Dell Medical School, University of Texas at Austin, Austin, TX, USA
| | - Bruce P Hermann
- Department of Neurology, University of Wisconsin, School of Medicine and Public Health, USA
| | - Dave Clarke
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, TX, USA; Comprehensive Pediatric Epilepsy Center, Dell Children's Medical Center, Austin, TX, USA; Department of Pediatrics, Dell Medical School, University of Texas at Austin, Austin, TX, USA; Department of Neurosurgery, Dell Medical School, University of Texas at Austin, Austin, TX, USA
| | - William A Schraegle
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, TX, USA; Comprehensive Pediatric Epilepsy Center, Dell Children's Medical Center, Austin, TX, USA; Department of Pediatrics, Dell Medical School, University of Texas at Austin, Austin, TX, USA.
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Operto FF, Labate A, Aiello S, Perillo C, de Simone V, Rinaldi R, Coppola G, Pastorino GMG. The Ketogenic Diet in Children with Epilepsy: A Focus on Parental Stress and Family Compliance. Nutrients 2023; 15:nu15041058. [PMID: 36839414 PMCID: PMC9958546 DOI: 10.3390/nu15041058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/13/2023] [Accepted: 02/17/2023] [Indexed: 02/23/2023] Open
Abstract
(1) Background: The aim of our study was to evaluate parental stress after 6 and 12 months of a ketogenic diet, considering demographic and clinical variables (epilepsy type, epilepsy duration, seizure number, antiseizure medications, comorbidities, efficacy, and adverse events). (2) Methods: We consecutively enrolled 36 children aged between 3 and 10 years who had been diagnosed with various types of drug-resistant epilepsy and who were in therapy with a ketogenic diet for better seizure control. A standardized neuropsychological questionnaire (Parenting Stress Index-PSI) was administered to the parents evaluating parental stress at baseline (T0), after 6 (T1) months, and after 12 months (T2). (3) Results: After 6 and 12 months of dietary treatment, Parental Distress and Total Stress mean scores were statistically significantly increased. Post hoc analysis showed no significant changes in the scores between T0 and T1, although there was a significant increase between T1 and T2. We did not find statistically significant relationships between parental stress and the other variables considered. (4) Conclusions: The ketogenic diet can be challenging for parents and can affect the perception of parental stress, especially in the long term. Parents may feel inadequate in their role; therefore, they should be helped and encouraged through additional supports in order to maximize the adherence to diet therapy.
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Affiliation(s)
- Francesca Felicia Operto
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery, and Odontoiatry, University of Salerno, 84084 Salerno, Italy
- Correspondence: ; Tel.: +39-347-174-5041
| | - Angelo Labate
- Neurophysiopatology and Movement Disorders Clinic, University of Messina, 98122 Messina, Italy
| | - Salvatore Aiello
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery, and Odontoiatry, University of Salerno, 84084 Salerno, Italy
| | - Cristina Perillo
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery, and Odontoiatry, University of Salerno, 84084 Salerno, Italy
| | - Valeria de Simone
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery, and Odontoiatry, University of Salerno, 84084 Salerno, Italy
| | - Rosetta Rinaldi
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery, and Odontoiatry, University of Salerno, 84084 Salerno, Italy
| | - Giangennaro Coppola
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery, and Odontoiatry, University of Salerno, 84084 Salerno, Italy
| | - Grazia Maria Giovanna Pastorino
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery, and Odontoiatry, University of Salerno, 84084 Salerno, Italy
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Operto FF, Orsini A, Sica G, Scuoppo C, Padovano C, Vivenzio V, de Simone V, Rinaldi R, Belfiore G, Mazza R, Aiello S, Vetri L, Donadio S, Labate A, Pastorino GMG. Perampanel and childhood absence epilepsy: A real life experience. Front Neurol 2022; 13:952900. [PMID: 36034267 PMCID: PMC9404324 DOI: 10.3389/fneur.2022.952900] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 07/18/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives The aim of our study was to evaluate the effectiveness and tolerability of perampanel (PER) as first add-on and as second line monotherapy in subjects with childhood absence epilepsy. Methods Our sample consisted of 20 patients with childhood absence epilepsy, aged between 8 and 10, already in therapy with a first antiseizure medication with incomplete seizure control. PER was added as first add-on in a dose ranging from 3 to 8 mg/die with 1- 2 mg/week increments. The patients that were seizure-free were shifted to a PER monotherapy. All patients underwent a standardized neuropsychological evaluation in order to assess non-verbal intelligence and executive functions before adding PER and after 6 months of drug therapy. All parents completed two questionnaires, in order to assess the emotional-behavioral problems and parental stress. Results 15/20 patients responded to add-on PER and were seizure-free, in 3/20 patients we observed a reduction of seizure frequency <50%, and in the 2 remaining patients the add-on therapy with PER did not lead to a reduction in seizures frequency from baseline. The patients who were seizure-free were switched to PER monotherapy. 9/15 patients remained seizure-free in monotherapy with PER. In the first month of therapy with PER 2/20 patients (10%) reported mild, transient side effects of irritability, headache and dizziness, which did not lead to discontinuation of therapy. Adjunctive treatment with PER did not negatively affect non-verbal intelligence, executive functions, emotional/behavioral symptoms of children and parental stress levels. Significance Our clinical experience in real life showed that PER appears to be effective in the control of absence seizures in childhood absence epilepsy, with a favorable tolerability profile. PER would seem effective on absence seizures even in monotherapy. Further studies with larger samples, longer follow-up and controlled vs. placebo (or other first choice antiseizure medications) are needed to confirm our data.
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Affiliation(s)
- Francesca Felicia Operto
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
- *Correspondence: Francesca Felicia Operto
| | - Alessandro Orsini
- Pediatric Neurology, Pediatric Department, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | | | - Chiara Scuoppo
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Chiara Padovano
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Valentina Vivenzio
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Valeria de Simone
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Rosetta Rinaldi
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Gilda Belfiore
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Roberta Mazza
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Salvatore Aiello
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Luigi Vetri
- OASI Research Institute- IRCCS, Troina, Italy
| | - Serena Donadio
- Department of Psychology, Educational and Science and Human Movement, University of Palermo, Palermo, Italy
| | - Angelo Labate
- Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - Grazia Maria Giovanna Pastorino
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
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10
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Operto FF, Coppola G, Vivenzio V, Scuoppo C, Padovano C, de Simone V, Rinaldi R, Belfiore G, Sica G, Morcaldi L, D’Onofrio F, Olivieri M, Donadio S, Roccella M, Carotenuto M, Viggiano A, Pastorino GMG. Impact of COVID-19 Pandemic on Children and Adolescents with Neuropsychiatric Disorders: Emotional/Behavioral Symptoms and Parental Stress. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073795. [PMID: 35409479 PMCID: PMC8997638 DOI: 10.3390/ijerph19073795] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/15/2022] [Accepted: 03/17/2022] [Indexed: 12/11/2022]
Abstract
The objective of our study was to evaluate the impact of the COVID-19 pandemic on the emotional and behavioral symptoms in minors with neuropsychiatric disorders and on parental stress through a standardized neuropsychological assessment, comparing the data collected before the pandemic with those collected during the lock-down. Another goal of our study was to analyze the relationship between parental stress and behavioral/emotional symptoms in children. Our study was conducted on 383 families of patients who had already been referred at the Child Neuropsychiatry Unit of the University Hospital of Salerno for different neuropsychiatric conditions. All the parents completed two neuropsychological standardized questionnaires for the assessment of parental stress (PSI—Parenting Stress Index-Short Form) and the emotional/behavioral problems of their children (Child Behaviour CheckList). The data collected during the pandemic were compared with those collected from questionnaires administered during the six months preceding the pandemic, as is our usual clinical practice. The comparison between the mean scores of PSI and CBCL before and after the pandemic showed a statistically significant increase in all subscales analyzed in the total sample. The correlation analysis showed significant positive relationship between the subscale Total Stress of PSI and the subscales Total Problems and Internalizing Problems of CBCL. Our study suggested that the COVID-19 pandemic and the corresponding measures adopted led to an increase in internalizing and externalizing symptoms in children and adolescents with neuropsychiatric disorder. Similarly, parental stress increased during COVID-19 and ahigher level of stress in parents can be related to the internalizing symptoms of their children.
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Affiliation(s)
- Francesca Felicia Operto
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (G.C.); (V.V.); (C.S.); (C.P.); (V.d.S.); (R.R.); (G.B.); luciaa-@hotmail.it (L.M.); (F.D.); (M.O.); (A.V.); (G.M.G.P.)
- Correspondence:
| | - Giangennaro Coppola
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (G.C.); (V.V.); (C.S.); (C.P.); (V.d.S.); (R.R.); (G.B.); luciaa-@hotmail.it (L.M.); (F.D.); (M.O.); (A.V.); (G.M.G.P.)
| | - Valentina Vivenzio
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (G.C.); (V.V.); (C.S.); (C.P.); (V.d.S.); (R.R.); (G.B.); luciaa-@hotmail.it (L.M.); (F.D.); (M.O.); (A.V.); (G.M.G.P.)
| | - Chiara Scuoppo
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (G.C.); (V.V.); (C.S.); (C.P.); (V.d.S.); (R.R.); (G.B.); luciaa-@hotmail.it (L.M.); (F.D.); (M.O.); (A.V.); (G.M.G.P.)
| | - Chiara Padovano
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (G.C.); (V.V.); (C.S.); (C.P.); (V.d.S.); (R.R.); (G.B.); luciaa-@hotmail.it (L.M.); (F.D.); (M.O.); (A.V.); (G.M.G.P.)
| | - Valeria de Simone
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (G.C.); (V.V.); (C.S.); (C.P.); (V.d.S.); (R.R.); (G.B.); luciaa-@hotmail.it (L.M.); (F.D.); (M.O.); (A.V.); (G.M.G.P.)
| | - Rosetta Rinaldi
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (G.C.); (V.V.); (C.S.); (C.P.); (V.d.S.); (R.R.); (G.B.); luciaa-@hotmail.it (L.M.); (F.D.); (M.O.); (A.V.); (G.M.G.P.)
| | - Gilda Belfiore
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (G.C.); (V.V.); (C.S.); (C.P.); (V.d.S.); (R.R.); (G.B.); luciaa-@hotmail.it (L.M.); (F.D.); (M.O.); (A.V.); (G.M.G.P.)
| | - Gianpiero Sica
- Azienda Sanitaria Locale Salerno, Via Nizza 146, 84124 Salerno, Italy;
| | - Lucia Morcaldi
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (G.C.); (V.V.); (C.S.); (C.P.); (V.d.S.); (R.R.); (G.B.); luciaa-@hotmail.it (L.M.); (F.D.); (M.O.); (A.V.); (G.M.G.P.)
| | - Floriana D’Onofrio
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (G.C.); (V.V.); (C.S.); (C.P.); (V.d.S.); (R.R.); (G.B.); luciaa-@hotmail.it (L.M.); (F.D.); (M.O.); (A.V.); (G.M.G.P.)
| | - Miriam Olivieri
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (G.C.); (V.V.); (C.S.); (C.P.); (V.d.S.); (R.R.); (G.B.); luciaa-@hotmail.it (L.M.); (F.D.); (M.O.); (A.V.); (G.M.G.P.)
| | - Serena Donadio
- Department of Psychology, Educational and Science and Human Movement, University of Palermo, 90128 Palermo, Italy; (S.D.); (M.R.)
| | - Michele Roccella
- Department of Psychology, Educational and Science and Human Movement, University of Palermo, 90128 Palermo, Italy; (S.D.); (M.R.)
| | - Marco Carotenuto
- Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, University of Campania “Luigi Vanvitelli”, 80100 Naples, Italy;
| | - Andrea Viggiano
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (G.C.); (V.V.); (C.S.); (C.P.); (V.d.S.); (R.R.); (G.B.); luciaa-@hotmail.it (L.M.); (F.D.); (M.O.); (A.V.); (G.M.G.P.)
| | - Grazia Maria Giovanna Pastorino
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (G.C.); (V.V.); (C.S.); (C.P.); (V.d.S.); (R.R.); (G.B.); luciaa-@hotmail.it (L.M.); (F.D.); (M.O.); (A.V.); (G.M.G.P.)
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11
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Lu HH, Tsai CY, Chou IC, Tsai JD. The impact of parenting stress on parents of school-age children with drug-resistant epilepsy. Front Pediatr 2022; 10:948286. [PMID: 36210939 PMCID: PMC9533100 DOI: 10.3389/fped.2022.948286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 09/05/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Psychological burdens can affect the quality of life among parents of children with epilepsy, especially parents of children with poor seizure control. The impact of stress on the parents of children with epilepsy is significantly comorbid with their children's cognitive dysfunction and the severity of epilepsy. The aim of this study was to assess the stress levels of parents of school-age children with drug-resistant epilepsy (DRE) and controlled-epilepsy after considering the children's cognitive ability. METHODS The study participants consisted of 35 children with typical development in the control group, 25 in the controlled-epilepsy group, 26 in the DRE group, and their parents. We used the Chinese version of the Parenting Stress Index (PSI) to measure the stress levels of all parents; and the Wechsler intelligence scale for children-fourth edition (WISC-IV) Chinese version to assess the children's cognition levels. RESULTS Parenting stress was significantly higher among the parents of children with DRE than of those in the control and controlled-epilepsy group. The PSI's child domain showed statistically significant subscales of adaptability, acceptability, demandingness, and distractibility/hyperactivity. Moreover, the high-risk ratio on the acceptability, adaptability, demandingness, and distractibility/hyperactivity subscales were also higher for the DRE group than for the controlled-epilepsy group and for the control group. CONCLUSION Seizure severity significantly influences parenting stress after considering cognitive dysfunction in children with epilepsy. Therefore, pediatricians and clinicians should consider epilepsy-specific stress in parents of children with DRE.
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Affiliation(s)
- Hsin-Hui Lu
- Department of Psychology, Chung Shan Medical University, Taichung, Taiwan.,Clinical Psychological Room, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Chun-Yu Tsai
- Department of Psychology, Chung Shan Medical University, Taichung, Taiwan
| | - I-Ching Chou
- Division of Pediatrics Neurology, China Medical University Children's Hospital, Taichung, Taiwan.,Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
| | - Jeng-Dau Tsai
- Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan
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