Severity of depressive symptomatology and functional impairment in children and adolescents with temporal lobe epilepsy

Objective: Depression is a frequent psychiatric disorder in children with temporal lobe epilepsy (TLE). However, severity of depressive symptoms (DS) is frequently neglected in these patients. This study aimed to determine severity of DS and global functioning by using quantitative measures and to establish their correlation with patients' demographics and clinical variables. Methods: 31 children (mean age of 11.8 +/- 2.3 years) with TLE were assessed with K-SADS-PL for axis I DSM-IV diagnosis. Severity of DS was measured by Children Depression Rating Scale-Revised - CDRS-R. Global functional impairment was evaluated with Child Global Assessment Scale-CGAS. Results: 25 patients (56% boys; 12 +/- 2.3 years) had current DS, moderate or severe in 84% according to CDRS-R T-Score. Severity of DS was not correlated with age (p = 0.377), gender (p = 0.132), seizure control (p = 0.936), age of onset (p = 0.731), duration of epilepsy (p = 0.602) and the presence of hippocampal sclerosis (p = 0.614). Patients had moderate to major functional impairment measured by CGAS (48.7 +/- 8.8), being adolescents more impaired than children (p = 0.03). Impairment of global functioning was not associated with epilepsy variables (p > 0.05). Conclusion: Children with TLE had moderate to severe DS early in the course of their disease with a relevant impact on their global functional activities, especially considering adolescents. Epilepsy severity seems not to be correlated to the severity of DS, contradicting the idea of a cause-consequence relationship. More systematic research is needed to better understand the association of depressive disorders in children and adolescents with TLE. (C) 2013 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.