Suresh Gurbani

Depression and Anxiety Disorders in Pediatric Epilepsy

Summary:  Purpose: This study examined affective disorders, anxiety disorders, and suicidality in children with epilepsy and their association with seizure‐related, cognitive, linguistic, family history, social competence, and demographic variables.

Childhood absence epilepsy: behavioral, cognitive, and linguistic comorbidities.

Purpose:  Evidence for a poor psychiatric, social, and vocational adult outcome in childhood absence epilepsy (CAE) suggests long‐term unmet mental health, social, and vocational needs. This cross‐sectional study examined behavioral/emotional, cognitive, and linguistic comorbidities as well as their correlates in children with CAE.

Behavioral Disorders in pediatric epilepsy: Unmet psychiatric need

Summary:  Purpose: This study examined the relation between psychiatric diagnosis and mental health services in children with epilepsy and the associated demographic, cognitive, linguistic, behavioral, and seizure‐related variables.

Psychopathology and pediatric complex partial seizures: seizure-related, cognitive, and linguistic variables.

Summary:  Purpose: This study examined the role of cognition, language, seizure‐related, and demographic variables in the psychopathology of children with complex partial seizure disorder (CPS) of average intelligence.

Frontal and temporal volumes in Childhood Absence Epilepsy.

Purpose:  This study compared frontotemporal brain volumes in children with childhood absence epilepsy (CAE) to age‐ and gender‐matched children without epilepsy. It also examined the association of these volumes with seizure, demographic, perinatal, intelligence quotient (IQ), and psychopathology variables.

Social competence in pediatric epilepsy: insights into underlying mechanisms

This study compared parent-based Child Behavior Checklist (CBCL) social competence scores of 90 children with complex partial seizures (CPS) and 62 with absence epilepsy (CAE) of average intelligence with scores of 91 healthy children. It also examined the role of seizure-related, cognitive, behavioral, linguistic, social communication, and demographic variables on these measures. When differences in cognitive, linguistic, and demographic variables were controlled for, the CPS and CAE groups had significantly lower scores in the school, but not in the social interaction and activities domains compared with the healthy control group. Among the patients, lower Full Scale IQ externalizing behaviors, disruptive disorders, minority status, and impaired social communication, but not seizure variables, predicted lower social competence scores. These findings demonstrate the importance of controlling for cognitive, behavioral, and demographic variables in social competence studies of children with CPS and CAE and the need to assess cognition and behavior when parents report school and social problems in these children.

Stimulant medications for the treatment of ADHD: Efficacy and limitations

A large literature exists on the use of stimulant medications to treat children with attention deficit hyperactivity disorder (ADHD). In 1993, we summarized this literature in a “review of reviews” for the U.S.Department of Education, as part of the Individuals with Disabilities Education Act (IDEA)—inspired changes in regulations about the identification and treatment of ADHD students in public schools. Ten critical issues were identified by panels of experts, and based on the literature consensus, views were identified for each topic, which provided an evaluation of strengths and weaknesses of stimulant pharmacotherapy. In this article, we provide an update of the “review of reviews” by identifying new investigations relevant to critical areas that might change the consensus views. We also summarize the recent presentations of the initial results of the MTA Study (Multimodality Treatment study of children with ADHD), which addresses many of the critical issues. We draw conclusions about the current views on strengths and weaknesses of stimulant pharmacotherapy based on this historical approach and selective review of recent research. MRDD Research Reviews 1999;5:215–224.

Language in pediatric epilepsy

Purpose:  This study examined the severity and range of linguistic impairments in young, intermediate, and adolescent youth with epilepsy and how these deficits were associated with illness effects, nonverbal intelligence, psychopathology, and reading.

Cognition, academic achievement, language, and psychopathology in pediatric chronic epilepsy: Short-term outcomes.

Children with epilepsy and control children were followed over a 2-year interval. Comorbidities of epilepsy, often defined as problems related to IQ, academic achievement, language, and psychopathology, were evaluated prospectively. It was hypothesized that over time (1) the presence of comorbidities would predict worse outcomes, and (2) epilepsy variables would negatively impact comorbidities. The study included 39 children with complex partial seizures (CPS), 25 children with childhood absence epilepsy (CAE), and 27 healthy children, aged 7.6-16.1years. The findings were notable for stability over the interval in all three groups. Additionally, baseline seizure variables and change over the interval appear to play a role in IQ and math achievement scores of children with epilepsy with average IQ and in the reading achievement scores of those with below-average IQ. However, seizure variables at baseline and follow-up were not predictors of DSM-IV diagnoses, depression, anxiety, or behavioral problems.

Thought disorder: A developmental disability in pediatric epilepsy

This study compared thought disorder (i.e., impaired use of language to formulate and organize thoughts) in 93 children with complex partial seizures (CPSs) and 56 children with primary generalized epilepsy with absence (PGE) and its relationship to age, seizure, cognitive, and linguistic variables. By the use of psychopathology, social competence, academic achievement, and school problem measures, the functional implications of thought disorder in these two groups were compared. When demographic variables were controlled for, there were no significant differences in thought disorder scores between the CPS and PGE groups. However, the profile of age, gender, seizure, and cognitive variables related to thought disorder differed in the CPS and PGE groups. Within each group, different aspects of thought disorder were associated with different seizure variables. Thought disorder was related to psychopathology, school problems, decreased academic achievement, and poor peer interaction in the CPS group, but with school problems in the PGE group. These findings suggest that CPS and PGE affect the normal maturation of childrens discourse skills, albeit through different mechanisms. The relationship of thought disorder to behavioral, academic, and social problems implies that these discourse deficits are one component of the developmental disabilities or comorbidities associated with pediatric CPS and PGE.