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

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.
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).
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.
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.