The influence of patient, caregiver, and family factors on symptoms of anxiety and depression in children and adolescents with intractable epilepsy

Klajdi Puka; Elysa Widjaja; Mary Lou Smith

doi:10.1016/j.yebeh.2016.12.011

The influence of patient, caregiver, and family factors on symptoms of anxiety and depression in children and adolescents with intractable epilepsy

Epilepsy Behav. 2017 Feb:67:45-50. doi: 10.1016/j.yebeh.2016.12.011. Epub 2017 Jan 12.

Authors

Klajdi Puka¹, Elysa Widjaja², Mary Lou Smith³

Affiliations

¹ Department of Psychology, Hospital for Sick Children, Toronto, Ontario, Canada.
² Division of Neurology, Hospital for Sick Children, Toronto, Ontario, Canada; Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada.
³ Department of Psychology, Hospital for Sick Children, Toronto, Ontario, Canada; Neurosciences and Mental Health Program, Hospital for Sick Children, Toronto, Ontario, Canada; Department of Psychology, University of Toronto Mississauga, Mississauga, Ontario, Canada. Electronic address: marylou.smith@utoronto.ca.

PMID: 28088680
DOI: 10.1016/j.yebeh.2016.12.011

Abstract

Objective: The objective was to evaluate the association of caregiver and family factors with symptoms of anxiety and depression in children and adolescents with medically refractory localization-related epilepsy (i.e., failed at least two epilepsy medications).

Method: Forty-four children (ages 6-11years) and 65 adolescents (ages 12-18years) and their parents participated in this multicentered, observational, cross-sectional study. Univariable and multivariable linear regressions were used to evaluate the influence of multiple patient, caregiver, and family characteristics on self-reported symptoms of anxiety and depression in the children and adolescents.

Results: Among children, depressive symptoms were associated with a lower proportion of life with seizures (β=.344, p=.022), caregiver depression (β=.462, p=.002), poorer family relationships (β=.384, p=.010), and poorer family mastery and social support (β=.337, p=.025); in multivariable analysis, proportion of life with epilepsy and parental depression remained significant. No significant predictors of anxiety were found among children. Among adolescents, depressive symptoms were associated with caregiver unemployment (β=.345, p=.005) and anxiety (β=.359, p=.003), low household income (β=.321, p=.012), poorer family mastery and social support (β=.334, p=.007), and greater family demands (β=.326, p=.008); in multivariable analysis, caregiver unemployment and anxiety remained significant. Greater anxiety symptoms among adolescents were associated with females (β=.320, p=.009) and caregiver depression (β=.246, p=.048) and anxiety (β=.392, p=.001) and poorer family mastery and social support (β=.247, p=.047); in multivariable analysis, female sex and caregiver anxiety remained significant.

Significance: These findings highlight the central role of caregiver psychopathology, which is amenable to intervention, on children and adolescents' symptoms of anxiety and depression. Addressing caregiver psychopathology may improve children and adolescents' quality of life even if seizure control is not attained.

Keywords: Comorbidity; Family environment; Parent; Psychiatric; Psychopathology.

MeSH terms

Adolescent
Anxiety / epidemiology
Anxiety / psychology*
Caregivers / psychology*
Child
Cross-Sectional Studies
Depression / epidemiology
Depression / psychology*
Drug Resistant Epilepsy / epidemiology
Drug Resistant Epilepsy / psychology*
Family / psychology*
Female
Humans
Male
Parents / psychology
Patient Participation / psychology*
Quality of Life / psychology
Self Report
Social Support

Grants and funding

MOP-133708/CIHR/Canada