Screening for Behavioural Abnormality Using Strength & Difficulty Questionnaire (SDQ) in Children with Epilepsy

Toral Gandhi; Amita  surana; Vandana Desai

doi:10.55489/njcm.140520232771

Authors

Toral Gandhi Surat Municipal Institute of Medical Education and Research, Surat, India
Amita surana Surat Municipal Institute of Medical Education and Research, Surat, India
Vandana Desai Surat Municipal Institute of Medical Education and Research, Surat, India

DOI:

https://doi.org/10.55489/njcm.140520232771

Keywords:

Children , Epilepsy , Behaviour, SDQ Scale, Risk Factor

Abstract

Aims: To estimate the problem of behavioural co morbidity and to determine risk factors associated with epilepsy in children.

Methods: A prospective observational study using Hindi and Gujarati version of Strength & Difficulty questionnaire (SDQ) was conducted. Children aged 6 to 17 years with epilepsy (CWE) as cases & without epilepsy as controls enrolled. Detailed demographic and clinical data were recorded. The total difficulty score and the subscale scores were compared between two groups. Comparison of the scores were done among the children with epilepsy group also.

Results: 52 children in each group were included. Self-reported SDQ used in 76% and parent reported SDQ used in 27% participants. Prevalence of behaviour abnormality was 25% in CWE. (p 0.004). CWE had significantly higher mean total difficulty score (p<0.001) and mean emotional (p <0.0001) and conduct subscale score (p 0.0024). Children having uncontrolled epilepsy (OR 15, 95% CI 2.9 - 76.3, p 0.0005) and having number of seizures more than 3 (OR 13.33 95% CI 3.4 - 51.04, p 0.0004) were found to be significantly associated with behavioural abnormality.

Conclusion: Epileptic children are at more risk of behavioural problem than in normal children, especially emotional problem and conduct problem. Uncontrolled epilepsy and frequency of seizure were significant risk factor for occurrence of behavioural problem.

References

Mittal R. Seizures, Epilepsy and nonepileptic events. In: A Parthsarathy,PSN Menon. IAP textbook of Pediatrics; 7th edition. New Del-hi (India): Jaypee Brothers;2019. 451 - 473

Shu-Hao Wei, Wang-Tso-Lee. Comorbidity of childhood epilepsy. J of Formosan med Ass. 2015; 114: 1031-1038. Doi: https://doi.org/10.1016/j.jfma.2015.07.015 PMid:26341150

Chaudhary A, Gulati S, sagar R, Kabra M, Sapra S. Behavioral comorbidity in children and adolescents with epilepsy. J Clin Neurosci. Aug 2014;21 (8): 1337-40. Doi: https://doi.org/10.1016/j.jocn.2013.11.023 PMid:24629398

Mishra OP, Upadhyay A, Prasad R, Upadhyay SK, Piplani SK. Behavioral problems in Indian children with epilepsy. Indian Pediatrics. 2017;54:116-120. Doi: https://doi.org/10.1007/s13312-017-1012-7 PMid:28031547

Salayev KA, Sanne B, Salayev R. Psychiatric and Behavioural Problems in Children and Adolescents with Epilepsy. East Asian Arch Psychiatry. 2017 Sep;27(3):106-14. PMID: 28993543.

Nair S, Ganjiwale J, Kharod N et al. Epidemiological survey of mental health in adolescent school children of Gujarat, India. BMJ Pedi-atrics open. 2017;1:e000139. Doi: https://doi.org/10.1136/bmjpo-2017-000139 PMid:29637154 PMCid:PMC5862196

Goodman R. the strength and difficulties questionnaire: A research note. J. Child Psychol. Psychiat.1997; 38 (5): 581-586. Doi: https://doi.org/10.1111/j.1469-7610.1997.tb01545.x PMid:9255702

Bhola P, Sathyanarayan V, Rekha DP, Daniel S, Thomas T. Assessment of Self-reported emotional and behavioraldifficulties among pre-university college students in Banglore, India. Indian J community Med. Apr-June 2016;41 (2):146-50. Doi: https://doi.org/10.4103/0970-0218.177536 PMid:27051090 PMCid:PMC4799638

Kariuki SM, Abubakar A, Holding PA, et al. Behavioral problems in children with epilepsy in rural Kenya. Epilepsy Behav. 2012;23(1):41-46. Doi: https://doi.org/10.1016/j.yebeh.2011.10.017 PMid:22119107 PMCid:PMC3405525

Rutter M, Graham P, Yule W. A Neuropsychiatric Study in Childhood. London: Spastics International Medical Publications. 1970.

Novriska D, Sutomo R, Setyati A. Behavioral problems in children with epilepsy. Dec.2014 ;54(6):324-. Doi: https://doi.org/10.14238/pi54.6.2014.324-9

Wani RT. Socioeconomic status scales-modified Kuppuswamy and Udai Pareekh's scale updated for 2019. J Family Med Prim Care. 2019 Jun;8(6):1846-1849. Doi: https://doi.org/10.4103/jfmpc.jfmpc_288_19 PMid:31334143 PMCid:PMC6618222

Malins AJ. Malins intelligence scale for children - Manual. Lucknow: Indian psychological corporation;1969

Anita M, Gajre MP, Setia Maninder S (2016) Neurobehavioral Comorbidities in Children with Epilepsy. J Neurol Neurophysiol 7: 371. Doi: https://doi.org/10.4172/2155-9562.1000371

Data SS, Premkumar ST, Chandy S et al. Behaviour problems in children and adolescents with seizure disorder: associations and risk factorsApril 2005;14 (3): 190-197. Doi: https://doi.org/10.1016/j.seizure.2005.01.007 PMid:15797354

McDermott S, Mani S, Krishnawami S. A population-based analysis of specific behavior problems associated with childhood sei-zures. Journal of epilepsy. 1995 Jan;8 (2):110-8. Doi: https://doi.org/10.1016/0896-6974(95)00019-A

Drewel EH, Bell DJ, Austin JK. Peer difficulties in children with epilepsy: association with seizure, neuropsychological, academic, and behavioral variables. Child Neuropsychol. 2009 Jul;15(4):305-20. Doi: https://doi.org/10.1080/09297040802537646 PMid:19093265

Huberty TJ, Austin JK, Harezlak J, Dunn DW, Ambrosius WT. Informant Agreement in Behavior Ratings for Children with Epilepsy. Epilepsy Behav. 2000 Dec;1(6):427-435. Doi: https://doi.org/10.1006/ebeh.2000.0119 PMid:12737832

Aloudari M, Delavar Kasmaei H, Aboutalebi Sh, Dehghan F, Rahmanpour N. Behavioral Problems in Iranian Epileptic Children; A Case Control Study. Int J Pediatr 2017; 5(12): 6713-19. DOI: 10.22038/ijp.2017.26377.2260.

Austin Jk, Caplan R. Behavioral and Psychiatric Comorbidities in Pediatric Epilepsy: Toward an Integrative Model.Epilepsia. 2017; 48(9):1639-1651. Doi: https://doi.org/10.1111/j.1528-1167.2007.01154.x PMid:17565593

Rodenburg R, Stams GJ, Meijer AM, Aldenkamp AP, Deković M. Psychopathology in children with epilepsy: a meta-analysis. J Pediatr Psychol. 2005 Sep;30(6):453-68. Doi: https://doi.org/10.1093/jpepsy/jsi071 PMid:16055484

Holmes GL. Pathogenesis of learning disabilities in epilepsy. Epilepsia. 2001;42 Suppl 1:13-5; discussion 19-20. Doi: https://doi.org/10.1046/j.1528-1157.2001.00504.x PMid:11422346

Henkin Y, Kishon-Rabin L, Pratt H, Kivity S, Sadeh M, Gadoth N. Linguistic processing in idiopathic generalized epilepsy: an auditory event-related potential study. Epilepsia. 2003 Sep;44(9):1207-17. Doi: https://doi.org/10.1046/j.1528-1157.2003.65402.x PMid:12919393

Smith ML, Elliott IM, Lach L. Cognitive skills in children with intractable epilepsy: comparison of surgical and nonsurgical candi-dates. Epilepsia. 2002 Jun;43(6):631-7. Doi: https://doi.org/10.1046/j.1528-1157.2002.26101.x PMid:12060023