Consensus-Based Standards for the Diagnosis and Treatment of Anxiety and Depression in Children and Adolescents with Epilepsy

The ILAE Pediatric Psychiatric Issues Task Force, a liaison between the Pediatrics and Psychiatric Commissions, has developed Consensus-Based Standards for the Diagnosis and Treatment of Anxiety and Depression in Children and Adolescents with Epilepsy.

We are seeking your comments prior to submitting to a journal for peer review.

Draft: Consensus-Based Standards for the Diagnosis and Treatment of Anxiety and Depression in Children and Adolescents with Epilepsy: A Report from the Psychiatric Pediatric Issues Task Force of the International League Against Epilepsy

Supplementary Material

Public comments are now closed and available for review below.

Comments

15 March 2024

Section 3.1.2 on treatment states: 'Two RCTs with non-pharmacological treatment included psychoeducation in a group 467 intervention [46] and physical activity [47]. These two trials had depression and/or anxiety 468 symptoms as secondary goals. They were both ineffective (Class III; SOE low)'.

Reference 46, PIE study, this was an early intervention psychosocial group therapy that specifically screened out participants meeting threshold for clinical depression/anxiety on BDI/BAI. Therefore, it is not correct to report as 'ineffective'. This is misleading and denigrates the important role that psychoeducation group therapies have for supporting the mental health of young people with epilepsy early in the problem cycle before they develop diagnosable psychiatric disorder.

Liam Dorris (UK)

6 March 2024

As far as I can understand, there was one study of 30 participants which showed improvement of depression with CBT. As a person with epilepsy, I did not find CBT because it relies upon the good cognition of a patient, and my processing memory etc. is impaired (see: https://jnnp.bmj.com/content/89/11/1129). Given the percentage of people with epilepsy that have depression, if possible, all those with epilepsy should be offered some support, irrespective of the scales. Psychoeducation about epilepsy, peer support, and the impact of support for carers and professionals on the child's well-being should also be considered.

Sharon Ross

24 February 2024

I so, so appreciate this work!!! It's very helpful, and there really are not many similar resources available. It would be super helpful if there could be a bit more description for some of the recommendations. In particular, which antiseizure medications are higher risk for psychiatric adverse effects? Are any ASMs lower risk for psychiatric adverse effects or even potentially beneficial for anxiety/depression (i.e. maybe oxcarbazepine, lamotrigine, pregabalin, gabapentin, etc. could be helpful for co-occuring anxiety/depression)? Also, are any particular SSRIs safer for seizures? Of those approved for child/adolescent depression/anxiety, which is preferred/lowest risk?

It would also be helpful to specify age range when providing recommendations for "children," when possible.

Thanks so much!!

Mia Strauss (USA)