Psychiatric comorbidities in pediatric epilepsy: a single-center retrospective study highlighting the burden of depressive symptoms.
- 1Pediatric Neurology Unit, Department of Maternal and Child Health and Urological Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
- 2Department of Pediatrics, University of Perugia, Perugia, Italy.
Abstract
Introduction
Epilepsy in the pediatric population is frequently associated with psychiatric comorbidities. Depression is of particular clinical significance given its elevated incidence and substantial impact on quality of life, treatment adherence, and psychosocial functioning. The prevalence of depression in children with epilepsy ranges from 7% to 14%, considerably higher than the 1-5% reported in the general pediatric population. The relationship between epilepsy and depression appears bidirectional: epilepsy predisposes to depressive disorders, and depression may increase seizure risk, suggesting shared neurobiological pathways. This study aimed to assess the prevalence of psychiatric symptoms in pediatric patients with epilepsy, with particular focus on depressive symptomatology, and to examine associations with etiological and clinical variables.Methods
This retrospective study included 240 pediatric patients (aged 2-18 years) diagnosed with epilepsy between 2013 and 2024. Psychiatric symptoms were ascertained retrospectively from clinical records. Patients were categorized into two groups: those with an identified genetic and/or structural abnormality (G1, n = 60) and those without (G2, n = 180). Statistical analysis employed the chi-squared test and Student's t-test (p < 0.05).Results
Psychiatric symptoms were identified in 30% of patients (72/240, 95% CI 24.2-35.8%). The most prevalent disorder was attention-deficit/hyperactivity disorder (ADHD; n = 30), followed by sleep disturbance/asthenia (n = 19), aggression/temper tantrums (n = 13), depressive/mood symptoms (n = 11), anxiety symptoms (n = 10), autism spectrum disorder (n = 6), eating behavior alterations (n = 4), self-harm (n = 4), adjustment/self-esteem features (n = 3), obsessive-compulsive disorder (OCD; n = 3), panic attacks (n = 2), and suicide attempts (n = 2). Psychiatric symptoms were significantly more prevalent in G1 (42%, 95% CI 29.2-54.1%) than in G2 (26%, 95% CI 19.7-32.5%; p = 0.03), corresponding to an odds ratio of 2.02 (95% CI 1.10-3.72). No significant associations were found between psychiatric symptoms and age, sex, family history, or treatment regimen.Discussion
Psychiatric comorbidities, including depressive symptomatology, are common in pediatric epilepsy and likely associated with underlying neurobiological factors. These findings support integrating neuropsychiatric screening, using validated instruments such as the Children's Depression Inventory-2 (CDI-2) and the Neurological Disorders Depression Inventory for Epilepsy-Youth version (NDDI-E-Y), into routine epilepsy care.
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BibTeX
@article{leonardis2026psychiatric,
title = {{Psychiatric comorbidities in pediatric epilepsy: a single-center retrospective study highlighting the burden of depressive symptoms.}},
author = {Arianna De Leonardis and Alberto Spalice and Alberto Verrotti and Isabella De Rosa and Simone Aloisio},
journal = {Frontiers in neurology},
year = {2026},
month = oct,
doi = {10.3389/fneur.2026.1951989},
url = {https://europepmc.org/article/MED/42908542},
note = {CC BY},
}
RIS
TY - JOUR
TI - Psychiatric comorbidities in pediatric epilepsy: a single-center retrospective study highlighting the burden of depressive symptoms.
AU - Arianna De Leonardis
AU - Alberto Spalice
AU - Alberto Verrotti
AU - Isabella De Rosa
AU - Simone Aloisio
PY - 2026
DA - 2026/10/07
JO - Frontiers in neurology
DO - 10.3389/fneur.2026.1951989
UR - https://europepmc.org/article/MED/42908542
AB - Introduction Epilepsy in the pediatric population is frequently associated with psychiatric comorbidities. Depression is of particular clinical significance given its elevated incidence and substantial impact on quality of life, treatment adherence, and psychosocial functioning. The prevalence of depression in children with epilepsy ranges from 7% to 14%, considerably higher than the 1-5% reported in the general pediatric population. The relationship between epilepsy and depression appears bidirectional: epilepsy predisposes to depressive disorders, and depression may increase seizure risk, suggesting shared neurobiological pathways. This study aimed to assess the prevalence of psychiatric symptoms in pediatric patients with epilepsy, with particular focus on depressive symptomatology, and to examine associations with etiological and clinical variables.Methods This retrospective study included 240 pediatric patients (aged 2-18 years) diagnosed with epilepsy between 2013 and 2024. Psychiatric symptoms were ascertained retrospectively from clinical records. Patients were categorized into two groups: those with an identified genetic and/or structural abnormality (G1, n = 60) and those without (G2, n = 180). Statistical analysis employed the chi-squared test and Student's t-test (p < 0.05).Results Psychiatric symptoms were identified in 30% of patients (72/240, 95% CI 24.2-35.8%). The most prevalent disorder was attention-deficit/hyperactivity disorder (ADHD; n = 30), followed by sleep disturbance/asthenia (n = 19), aggression/temper tantrums (n = 13), depressive/mood symptoms (n = 11), anxiety symptoms (n = 10), autism spectrum disorder (n = 6), eating behavior alterations (n = 4), self-harm (n = 4), adjustment/self-esteem features (n = 3), obsessive-compulsive disorder (OCD; n = 3), panic attacks (n = 2), and suicide attempts (n = 2). Psychiatric symptoms were significantly more prevalent in G1 (42%, 95% CI 29.2-54.1%) than in G2 (26%, 95% CI 19.7-32.5%; p = 0.03), corresponding to an odds ratio of 2.02 (95% CI 1.10-3.72). No significant associations were found between psychiatric symptoms and age, sex, family history, or treatment regimen.Discussion Psychiatric comorbidities, including depressive symptomatology, are common in pediatric epilepsy and likely associated with underlying neurobiological factors. These findings support integrating neuropsychiatric screening, using validated instruments such as the Children's Depression Inventory-2 (CDI-2) and the Neurological Disorders Depression Inventory for Epilepsy-Youth version (NDDI-E-Y), into routine epilepsy care.
SN - 1664-2295
ER -