The 1999 British Child and Adolescent Mental Health Survey, a nationwide epidemiological
study of rates of psychiatric disorder in children aged 5 to 15 years, provided the opportunity to
investigate the mental health of children with epilepsy. These children and their families
experience disability specifically because of additional emotional, behavioural, and relationship
problems, and this is the first epidemiological study that directly measures these impairments.
Information was obtained by interviewing a main carer and teacher for 10316 children; 67 children
with epilepsy were identified (35 males, 32 females; mean age 10 years 2 months, SD 2 years
11 months, range 5 to 15 years), and compared with the 47 children with diabetes (27 females,
20 males; mean age 10 years 4 months, SD 3 years 4 months, range 5 to 15 years) and 10202
controls (50% male; mean age 9 years 11 months, SD 3 years 1 month, range 5 to 15 years).
DSM-IV psychiatric diagnoses were derived from the Development and Well-Being Assessment in
combination with the interview and a specialist clinician rating. Parental reports of emotional
and behavioural problems, their impact, and associated peer problems were also obtained. Rates
of psychiatric disorder were 37% (95% confidence interval [CI] 22 to 49) in epilepsy,
11% (95% CI 2 to 19%) in diabetes, and 9% (95% CI 9 to 10%) in control children. Parents of
children with epilepsy consistently reported more problems, with greater impact and associated
peer problems. Epilepsy, but not diabetes, was independently (adjusted for age, sex, and severe
learning difficulties) associated with all behavioural variables in regression analyses.
Emotional, behavioural, and relationship difficulties are common in children with epilepsy,
and constitute a significant burden to the children and their families, indicating the need
for effective mental health services for these children.