Psychiatric comorbidities in a sample of Iranian children and adolescents with epilepsy

Introduction: Epilepsy is a common disorder worldwide, commonly starting during childhood. Despite the high impact of psychiatric comorbidities in these patients, little is known about Iranian children with epilepsy. Methods: This cross sectional study was carried out in the tertiary clinics of the Tabriz University of Medical Sciences, Tabriz, Iran. All of the children (aged between 6 and 18) with a diagnosis of epilepsy were enrolled in this study. A semi-structured psychiatric interview was carried out using the Farsi (Persian) version of the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL). Results: From a total of 298 participants, 270 (90.6%) completed the process, including 120 (44.4%) girls and 150 (55.6%) boys. At least one psychiatric diagnosis was made in 222 (82.2%) patients. The most prevalent psychiatric disorders in children and adolescents with epilepsy were attention deficit/hyperactivity disorder (34.4%), major depressive disorder (MDD) (29.6%), social phobia (14.8%) and oppositional defiant disorder (ODD) (14.8%). Agoraphobia and anorexia nervosa were significantly more prevalent among girls. The following disorders were more prevalent in children aged between 13 and 18: MDD (47.5%), psychotic disorder (2.5%), social phobia (23.7%), generalized anxiety disorder (GAD) (15.3%), conduct disorder (13.6%), chronic motor tic disorder (13.6%) and substance related disorders (4.8%). Separation anxiety (15.1%) and enuresis (1.5%), on the other hand, were more prevalent among younger children. A logistic regression model showed that psychiatric disorders in parents or siblings could independently predict at least one psychiatric comorbidity in children with epilepsy.Conclusion: Iranian children with epilepsy face a high burden of psychiatric and behavioral comorbidities compared to same aged general population that should be considered for comprehensive care.