Depression In Children With Epilepsy: Association With Ecological Executive Function

Objective Epilepsy is a common neurological disease in children.Depression is the most common psychiatric comorbidity in children with epilepsy(CWE),which seriously affects their learning,social interaction,treatment outcomes and quality of life.Previous studies have reported that CWE and depression patients have executive dysfunction.However,whether the level of executive function in CWE with depression is lower than that in CWE without depression is unclear,and there are few studies about the relationship between depression and executive function.The main purpose of this study was to investigate the depressive state and the features of ecological executive function in CWE,as well as the risk factors leading to depression or executive dysfunction in CWE,and explore the relationship between depression and executive function.Methods The research recruited 51 CWE from the First Affiliated Hospital of Anhui Medical University as the experimental subjects and 48 typically developing children as controlsubjects.Both groups completed Children's Depression Inventory(CDI)and Behavior Rating Inventory of Executive Function(BRIEF).The CWE were divided into two groups according to the CDI scores: epilepsy with depression and epilepsy without depression and then compared the BRIEF scores between the two groups.Moreover,multiple stepwise linear regression analysis was used to explore the effects of epileptic variables on depression and executive function.The relationship between depression and executive function was computed by means of Pearson's correlation.Results Of all 51 children with epilepsy,16 had depression,resulting in a comorbidity rate of 31.37%,which is significantly higher than the control group(P<0.05).The scores of Global Executive Composite(GEC),Behavioral Regulation Index(BRI)and Metacognition Index(MI)of BRIEF [ respectively,(54.10±9.64),51(44,58),(55.00±8.84)]were significantly higher than those of the control group[respectively,(43.83±6.86),41(40,44),(45.83±7.26)](P<0.05).Moreover,the patients with epilepsy and depression received higher scores in all sub factors of BRIEF as compared with the patients with epilepsy alone(all P<0.05).Multiple stepwise linear regression analysis showed that depression is closely related with seizure control while GEC is related with seizure control and antiepileptic drugs(AEDs).Pearson's correlation test showed that the scores of BRIEF(including GEC?BRI?MI?inhibition?shifting?emotional control?working memory?task initiation?planning/organizing?organization of materials?monitoring)had significantly positive correlations with the scores of depression(r=0.385?0.597,P<0.05).Conclusion Children with epilepsy have depression disorder and executive dysfunction compared with healthy controls.The patients with epilepsy and depression show more serious impairments of ecological executive function than those not have depression.Depression and executive function in children with epilepsy have significantcorrelations.