Department of Neurology and Psychiatry, Assiut University, 71516 Assiut, Egypt; Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK.
Department of Neurology and Psychiatry, Assiut University, 71516 Assiut, Egypt.
Epilepsy Res. 2021 Jan;169:106505. doi: 10.1016/j.eplepsyres.2020.106505. Epub 2020 Nov 21.
Attention deficit/hyperactivity disorder (ADHD) is a developmental disorder caused by structural and functional brain abnormalities as well as genetic and environmental factors. ADHD symptoms are commonly observed in individuals with epilepsy. A few studies have reported a pattern of behavioral problems in children with combined epilepsy and ADHD. We aimed to evaluate comorbid behavioral problems and mental health concerns among children with epilepsy with ADHD and without ADHD including autism spectrum disorder, anxiety, depression, somatic problems, oppositional defiant disorder, and conduct disorder.
A total of 100 children aged between 6 and 11 years were recruited and categorized into 1 of 5 groups (20 child/group): (1) epilepsy, (2) epilepsy with ADHD, (3) ADHD with electroencephalogram (EEG) changes, (4) ADHD without EEG changes, and (5) healthy control. The scales used in our study included the Childhood Autism Spectrum Test (CAST) to screen autism spectrum conditions and related social and communication conditions, Conners' Parent Rating Scale (CPRS) to assess ADHD and other comorbid behavioral and social-emotional difficulties, and Children Behavior Checklist (CBCL) to evaluate behavior problems.
The CAST scale score showed no significant difference among the studied groups. Regarding the Conners-3 scale, the combined type of ADHD was predominant in the ADHD with EEG changes group and the ADHD with epilepsy group, while hyperactive ADHD was predominant in the ADHD without EEG changes group. The ADHD with EEG changes group and the ADHD with epilepsy group had equally high clinical rating scores for CBCL in internalizing and externalizing problems. There was a significant difference in the profile of all Diagnostic and Statistical Manual of Mental Disorders (DSM-5) scales of CBCL among the studied groups.
This is the first study to use EEG in patients with ADHD in comparison with epilepsy. ADHD with epilepsy is closely related to ADHD with EEG changes regarding psychiatric comorbidity in terms of anxiety, depression, somatic problems, oppositional defiance problems, and conduct problems.
注意缺陷多动障碍（ADHD）是一种由结构性和功能性脑异常以及遗传和环境因素引起的发育障碍。ADHD 症状在癫痫患者中较为常见。一些研究报告了癫痫合并 ADHD 与单纯 ADHD 儿童的行为问题模式。我们旨在评估 ADHD 合并癫痫与单纯癫痫且不合并自闭症谱系障碍、焦虑、抑郁、躯体问题、对立违抗性障碍和品行障碍的儿童的共患行为问题和精神健康问题。
共招募了 100 名 6 至 11 岁的儿童，并将其分为 5 组（每组 20 名儿童）：（1）癫痫，（2）癫痫伴 ADHD，（3）ADHD 伴脑电图（EEG）改变，（4）ADHD 不伴 EEG 改变，（5）健康对照组。我们研究中使用的量表包括儿童自闭症谱系测试（CAST）以筛查自闭症谱系障碍及相关的社交和沟通障碍，康纳父母评定量表（CPRS）以评估 ADHD 及其他共患行为和社会情感问题，以及儿童行为检查表（CBCL）以评估行为问题。
CAST 量表评分在研究组之间无显著差异。关于 Conners-3 量表，在 ADHD 伴 EEG 改变组和 ADHD 伴癫痫组中，混合性 ADHD 占主导地位，而在 ADHD 不伴 EEG 改变组中，多动型 ADHD 占主导地位。ADHD 伴 EEG 改变组和 ADHD 伴癫痫组的 CBCL 内部和外部问题的临床评分均较高。在所有使用 DSM-5 量表的 CBCL 诊断和统计手册中，研究组之间的量表分布存在显著差异。
这是首次将 EEG 用于 ADHD 患者与癫痫患者的比较研究。ADHD 伴癫痫与 ADHD 伴 EEG 改变在焦虑、抑郁、躯体问题、对立违抗性问题和品行障碍方面存在密切的精神病共病关系。
