School performance and psychiatric comorbidity in childhood absence epilepsy: A Danish cohort study. (January 2023)

• Record Type: Journal Article
• Authors: Boesen, Magnus Spangsberg; Børresen, Malene Landbo; Christensen, Søren Kirchhoff; Klein-Petersen, Amalie Wandel; El Mahdaoui, Sahla; Sagar, Malini Vendela; Schou, Emilie; Eltvedt, Anna Korsgaard; Cacic Hribljan, Melita; Born, Alfred Peter; Uldall, Peter Vilhelm; Thygesen, Lau Caspar; Miranda, Maria Jose
• Is Part Of: European journal of paediatric neurology. Volume 42(2023)
• Page Start: 75
• Page End: 81
• Publication Date: 2023-01
• Subjects: Childhood absence epilepsy -- Prognosis -- School -- Psychiatric comorbidity -- ADHD; Pediatric neurology -- Periodicals; Nervous System Diseases -- Periodicals; Child -- Periodicals; Infant -- Periodicals; Neurologie pédiatrique -- Périodiques; Pediatric neurology; Electronic journals; Periodicals; Electronic journals; 618.928
• DOI: 10.1016/j.ejpn.2022.12.008
• Languages: English
• ISSNs: 1090-3798

Abstract

Abstract: The aim was to determine school performance and psychiatric comorbidity in children with childhood absence epilepsy (CAE). We reviewed the medical records in children with ICD-10 codes for idiopathic generalized epilepsy before 18 years of age, and pediatric neurologists confirmed the International League Against Epilepsy criteria for CAE were met. Control groups were the general pediatric population or children with non-neurological chronic disease. Outcomes were from nationwide and population-based registers on school performance and psychiatric comorbidity. We compared the mean grade point average using linear regression and estimated hazard ratios (HR) using Cox regression for the other outcomes. Analyses were adjusted for the child's sex, and year of birth, and parental highest education, receipt of cash benefits or early disability pension. We included 114 children with CAE with a median age at onset of 5.9 years (interquartile range = 4.5–7.3 years). Compared with both population controls and non-neurological chronically ill children, children with CAE had increased hazard of special needs education (HR = 2.7, 95% confidence interval (CI) = 1.8–4.1, p < 0.0001), lower grade point average at 9th grade by 1.7 grade points (95% CI = -2.5 to -1.0, p < 0.001), increased ADHD medicine use (HR = 4.4, 95% CI = 2.7–7.2, p < 0.001), increased sleep medicine use (HR = 2.7, 95% CI = 1.7–4.3, p < 0.001), and increased psychiatry visits (HR = 2.1, 95% CI = 1.1–4.0, p = 0.03). In conclusion, children with CAE have increased psychiatric comorbidity and a considerable proportion of these children receive special needs education in primary/secondary school, albeit insufficient to normalize their considerably lower grade point average in the 9th grade. Highlights: Children with childhood absence epilepsy compared with non-neurological chronically ill children (rheumatoid arthritis, inflammatory bowel disease, and type 1 diabetes) have: increased special needs education (hazard ratio (HR) = 2.7, 95% confidence interval (CI) = 1.8–4.1, p < 0.0001) lower grade point average in 9th grade by 1.7 points (95% CI = -2.4 to -0.9, p < 0.001) increased ADHD medicine use (HR = 4.4, 95% CI = 2.7–7.2, p < 0.001) increased sleep medicine use (HR 2.7, 95% CI = 1.7–4.3, p < 0.001) increased visits to psychiatry (HR = 2.1, 95% CI = 1.1–4.0, p = 0.03)