Comparing Mental Health of School-Age Children with and without Epilepsy

How to Cite This Article: Shamsaei F, Cheraghi F, Zamani Ghr. Comparing Mental Health of School-Age Children with and without Epilepsy: A Case Control Study. Iran J Child Neurol. Summer 2016; 10(3):35-41. AbstractObjectiveMental health problems frequently occur in children with epilepsy but the diagnosis is frequently missed and therapeutic opportunities are often lost. The aim of this study was to compare mental health statues between school-aged children with epilepsy and the healthy group.Materials & Methods In this case, control study, 120 children aged 6 to 12 years with idiopathic epilepsy and 240 healthy control groups were followed up. Children with epilepsy were enrolled from Iranian Epilepsy Association in 2014. The parent version of Child Symptom Inventory-4 questionnaire was used. Mean comparisons were performed using Student’s t test while effect sizes were estimated by Cohen’s d coefficient. The Chi-Square test was used to assess the difference between frequency distribution of demographic variables in both groups. The significance level was considered less than 0.05.ResultsThere were statistically significant differences between children with epilepsy and control group as for attention deficit hyperactivity disorder, generalized anxiety disorder, major depression, separation anxiety, social phobia, motor and vocal tics and oppositional defiant disorder.ConclusionThe carefully evaluating and prospectively following the psychopathology symptom of children with epilepsy are critical for early identification, prevention and treatment.ReferencesValizadeh L, Barzegar M, Akbarbegloo M, Zamanzadeh V, Rahiminia E, Ferguson CF. The relationship between psychosocial care and attitudes toward illness in adolescents with epilepsy. Epilepsy Behav 2013; 27(1):267-71.Russ SA, Larson K, Halfon N. A national profile of childhood epilepsy and seizure disorder. Pediatrics 2002; 129(2):256-264.Kotsopoulos IA, van Merode T, Kessels FG, de Krom MC, Knottnerus, JA. Systematic review and meta-analysis of incidence studies of epilepsy and unprovoked seizures. Epilepsia 2002; 43(11):402–1409.Sayehmiri K, Tavan H, Sayehmiri F, Mohamadi I, Carson KV. Prevalence of Epilepsy in Iran: A Meta-Analysis and Systematic Review. Iran J Child Neurol 2014; 8(4): 9–17.Salpekar JA, Dunn DW. Psychiatric and psychosocial consequences of pediatric epilepsy. Semin Pediatr Neurol 2007; 14(4): 181-8.Ott D, Siddarth P, Gurbani S, Koh S, Tournay A, Shields WD, Caplan R. Behavioral disorders in pediatric epilepsy: unmet psychiatric need. Epilepsia 2003; 44(4): 591-597.Davies S, Heyman I, Goodman R. A population survey of mental health problems in children with epilepsy. Dev Med Child Neurol 2003; 45(5):292-295.Maia Filho HS, Costa CRM, Gomes MM. Epilepsia e Saúde Mental na Infância. J Epilep Clin Neurophysiol 2006; 12(2):79-88.Gaitatzis A, Carroll K, Majeed A, Sander J. The epidemiology of the comorbidity of epilepsy in the general population. Epilepsia 2004; 45(2):1613-1622.Jones JE, Watson R, Sheth R, Caplan R, Koehn M, Seidenberg M, Hermann B. Psychiatric comorbidity in children with new onset epilepsy. Dev Med Child Neurol 2007; 49(7):493-7.Gadow KD, Sprafkin J. Child symptom inventory-4 Screening and norms manual. Stony Brook, NY: checkmate Plus Ltd, 2002.Dulcan MK, Mina K. Dulcan’s Textbook of Child and Adolescent Psychiatry. 1st ed, American Psychiatric Pub, 2010.Jafari N, Mohammadi MR, Khanbani M, Farid S, Chiti P. Effect of Play Therapy on Behavioral Problems of Maladjusted Preschool Children. Iran J Psychiatry 2011 6(1): 37–42.Hermann B, Jones J, Dabbs K, Allen CA, Sheth R, Fine J, McMillan A, Seidenberg M. The frequency, complications and etiology of ADHD in new onset pediatric epilepsy. Brain 2007; 130(Pt 12):3135-48.Kaner AM. Psychiatric Comorbidity in Children with Epilepsy … or Is It: Epilepsy Comorbidity in Children with Psychiatric Disorders? Epilepsy Curr 2008; 8(1): 10–12.Williams J Steel C, Sharp GB, DelosReyes E, Phillips T, Bates S, Lange B, Griebel ML. Parental anxiety and quality of life in children with epilepsy. Epilepsy Behav 2003; 4(5): 483–486.Stefanello S, Marín-Léon L, Fernandes PT, Li LM, Botega NJ. Depression and anxiety in a community sample with epilepsy in Brazil. Arq Neuropsiquiatria 2011; 69 (2):342-348.Dunn DW, Austin JK, Perkins SM. Prevalence of psychopathology in childhood epilepsy: categorical and dimensional measures. Dev Med Child Neurol 2009; 51(5):364-372.McDermott S, Mani S, Krishnaswami S. A population-based analysis of specific behavior problems associated with childhood seizures. J Epilepsy 1995; 8(2):110–118.Davies S, HeymanI Goodman R. Apopulation survey of mental health problems in children with epilepsy. Dev Med Child Neurol 2003; 45(5):292-295.Parisi R, Moavero R, Verrotti A, Curatolo P. Attention deficit hyperactivity disorder in children with epilepsy. Brain Dev 2010; 32(1):10–16

Emergency Medical Service Providers’ Perception of Health- Threatening Stressors in Emergency Missions: A qualitative Study

BACKGROUND: Unknown and unpredictable situations cause emergency medical service (EMS) providers to experience various stressful factors. These factors are affected by sociocultural conditions and expectations of the casualty and affect EMS providers' performance and health at the incident scene. The present study was conducted to explore EMS providers' perception of stressful and health-threatening factors in emergency missions.METHOD: This qualitative conventional content analysis was conducted in 2020. The participants included 16 EMS providers working at the Emergency Medical Services Department in Hamadan Province, Iran. The participants were selected using purposive sampling and underwent semi-structured interviews until data saturation. Data were analyzed using the Graneheim and Lundman method.RESULTS: Analysis of the interview data yielded six subcategories (i.e., incident scene hazards, violence-related injuries, physical injuries caused by patient care/handling, ambulance crash-related injuries, emotional impact of patients' suffering and ailments, and highly stressful missions), two main categories (i.e., physical injuries and psychological tensions), and a theme of occupational injuries.CONCLUSIONS: According to the results, in addition to having concerns about caring for patients and saving the injured, EMS providers also worry about potential threats to their own health. The present study identified and described some major stressors in emergency missions. Thus, for a better and more effective efficiency, the present study results can be used to reduce or modify stressors in EMS providers

Effect of adjuvant sleep hygiene psychoeducation and lorazepam on depression and sleep quality in patients with major depressive disorders: results from a randomized three-arm intervention

Sleep disturbances are a common co-occurring disturbance in patients with major depressive disorders (MDDs) and accordingly deserve particular attention. Using a randomized design, we investigated the effects of three different adjuvant interventions on sleep and depression among patients with MDD: a sleep hygiene program (SHP), lorazepam (LOR), and their combination (SHP-LOR).; A total of 120 outpatients with diagnosed MDD (mean age: 48.25 years; 56.7% females) and treated with a standard SSRI (citalopram at 20-40 mg at therapeutic level) were randomly assigned to one of the following three conditions: SHP (n=40), LOR (1 mg/d; n=40), SHP-LOR (1 mg/d; n=40). At the beginning and at the end of the study 8 weeks later, patients completed two questionnaires, the Pittsburgh Sleep Quality Index to assess sleep and the Beck Depression Inventory to assess symptoms of depression.; Sleep disturbances decreased over time and in all groups. No group differences or interactions were observed. Symptoms of depression decreased over time and in all three groups. Reduction in symptoms of depression was greatest in the SHP-LOR group and lowest in the LOR group.; The pattern of results suggests that all three adjuvant treatments improved symptoms of sleep disturbances and depression, with greater benefits for the SHP-LOR for symptoms of depression, but not for sleep. Nevertheless, risks and benefits of benzodiazepine prescriptions should be taken into account

Differential pattern of brain functional connectome in obsessive-compulsive disorder versus healthy controls

Researchers believe that recognition of functional impairment in some of brain networks such as frontal-parietal, default mode network (DMN), anterior medial prefrontal cortex (MPFC) and striatal structures could be a beneficial biomarker for diagnosis of obsessive-compulsive disorder (OCD). Although it is well recognized brain functional connectome in OCD patients shows changes, debate still remains on characteristics of the changes. In this regard, little has been done so far to statistically assess the altered pattern using whole brain electroencephalography. In this study, resting state EEG data of 39 outpatients with OCD and 19 healthy controls (HC) were recorded. After, brain functional network was estimated from the cleaned EEG data using the weighted phase lag index algorithm. Output matrices of OCD group and HCs were then statistically compared to represent meaningful differences. Significant differences in functional connectivity pattern were demonstrated in several regions. As expected the most significant changes were observed in frontal cortex, more significant in frontal-temporal connections (between F3 and F7, and T5 regions). These results in OCD patients are consistent with previous studies and confirm the role of frontal and temporal brain regions in OCD

Development and Psychometric Testing of the Stigma Assessment Tool for Family Caregivers of People with Mental Illness

Objective: This study aims to develop and validate the stigma assessment tool for family member caregivers of patients with mental illness (SAT-FAM). Methods: This study was conducted in three phases: (1) explicate the concept of stigma towards family caregivers of patients with mental illness, (2) develop and iteratively optimise a preliminary version of the SAT-FAM, and (3) test the psychometric properties of the final version of the SAT-FAM. In phase 1, 14 family caregivers of patients with mental illness were interviewed for qualitative data collection and analysis. Four themes emerged: people’s reaction and attitude, compassion with fear, rejection and loneliness, and confusion about mental illness. In phase 2, the first draft of the SAT-FAM with 38 items was developed. Based on the content validity index, each item was evaluated by 15 experts using a 4-point scale (1 = not relevant; 4 = very relevant). 15 family member caregivers of patients with mental illness were randomly selected to complete the face validity form on a Likert scale ranging from 1 (strongly disagree) to 4 (strongly agree). In phase 3, 286 family caregivers of people with mental illness were recruited for exploratory factor analysis. Internal consistency (Cronbach’s coefficient) and test-retest reliability were measured. Results: The final draft of the SAT-FAM comprised 30 items in four factors: shame and discrimination, social interaction, emotional reaction, and avoidance behaviours. The internal consistency (Cronbach’s alpha) was >0.89 for all factors. The test-retest reliability among 30 family caregivers was good (0.76). Conclusions: The SAT-FAM is a valid and reliable self-report instrument for assessing stigma towards family caregivers of patients with mental illness. It enables a practical way of evaluating interventions aimed at reducing stigma

The effect of training interventions of stigma associated with mental illness on family caregivers: a quasi-experimental study

Abstract Background Stigma is one of the most destructive features of mental illnesses that may affect the family caregivers. This study aimed to analyze the effect of training interventions of stigma on family caregivers of the mental illness patients. Materials and methods This quasi-experimental pre- and post-test study was performed on a single group of 43 family caregivers of mental illness patients in Hamadan Psychiatric Hospital, Iran, in 2015. The samples were taken through convenience sampling method and the data collection tool was a stigma questionnaire made by the researchers. The questionnaires were filled by the participants within pre-intervention and 1-month post-intervention. All the data were analyzed by SPSS version 16, and the mean and standard deviation by paired t test and Wilcoxon test. Results Findings of this study demonstrated that women included 60% of the family caregivers. The average age of caregivers and the duration of caregiving were 41.67 ± 11.62 years and 66.28 ± 7.99 months, respectively. The mean and standard deviation for pre-intervention stigma score were 82.47 ± 12.23 indicating that the family caregivers suffered from some problems arisen from living with mental patients. They include not getting married, unable to find a job, embarrassment, humiliation by others, disgrace, and shame. Our results revealed that the mean and standard deviation of stigma score decreased to 29.28 ± 7.52 after training, and this difference was statistically significant (P < 0.001). Conclusions According to the results of present study, training interventions reduce the issues caused by stigma and help the family members of mental patients to face and cope with the problem

Burden on Family Caregivers Caring for Patients with ‎Schizophrenia ‎

Objective: The aim of this study ‎was to determine the prevalence ‎of the burden reported by family ‎caregivers of Patients with ‎schizophrenia.‎ Methods: This cross sectional ‎study involved face-to-face ‎interviews with family caregivers ‎of patients with schizophrenia. ‎Using convenience sampling, ‎‎225 caregivers were selected ‎from Farshchian psychiatry ‎Hospital in Hamadan, Iran from ‎July to September 2012. ‎Measures included patients and ‎caregivers’ demographic ‎variables and caregivers’ burden ‎using the Zarit Burden Interview ‎‎(ZBI). Data were analyzed by ‎SPSS-18 with Pearson ‎correlation and t-test.‎ Results: Using the ZBI, we found ‎that 7.6% of the caregivers ‎experienced “no to low” burden, ‎‎23.5% “mild to moderate”, 41.8% ‎‎“moderate to severe” and 27.1% ‎‎“severe” burden. The mean ‎average score of the responses ‎to ZBI was 51.73 (SD: ± 18.23). ‎The level of burden experienced ‎was significantly associated with ‎age, gender, and educational ‎level, relation to care recipient, ‎caregiving duration and duration ‎of schizophrenia illness.‎ Conclusion:‎‏ ‏Mental health ‎professionals need to develop ‎more innovative programs for ‎families of schizophrenic ‎patients. Furthermore, as a ‎replacement for supporting the ‎families and easing their ‎burdens, it may be more ‎effective to include them in the ‎health care team by assigning ‎specific tasks and providing the ‎required resources to them to ‎perform such tasks

The relationship between stress and mothers communication patterns of educable mentally retarded children

Introduction: Birth of child with disability can put a lot of pressure on others, especially parents and eliminate all of the those dreams and fantasies about having a healthy child and cause problems in family relations and the development of destructive and negative emotions toward their child’s. The aim of this study was study the relationship between stress and communication patterns of mothers of educable mentally retarded children in schools for exceptional children of Hamadan City in 2015-16 curriculum year were done. Methods: In this descriptive- correlational study, all mothers of educable mentally retarded children in Hamadan City schools for exceptional children in the 2015-16 curriculum year that consisted of 53 females and 92 males were selected. Data collected by questionnaires: demographic questionnaire, Perceived Stress Scale (PSS-14) and Assessment Scale of mother-child relationship (MCRE) and analyzed by SPSS20. Results: The results of multiple correlation coefficient showed that stress has negative significance relationship with admission communication patterns (P=0/001), permissive (P=0/001) and rejection (P=0/001), but stress has no significance relationship with supportive patterns of communication. Conclusion: Based on the results obtained we can conclude having a disabled child creates to the extent stress for mothers that affected their patterns of communication by it, so it is suggested to maintain health and enhance quality of life of this mothers had implement some programs

Relationship between sleep quality and quality of life in patients with bipolar disorder

Objective: Sleep disorder is one of the most classic symptoms of patients with bipolar I disorder (BID), which affects their quality of life (QOL). The current study aimed to determine the relationship between sleep quality and quality of life in patients with bipolar I. Methods: In this descriptive cross-sectional study, 180 patients with bipolar I disorder were selected using convenience sampling in Farshchian Psychiatric Center of Hamadan, Iran, in 2017. The data collection instruments were Pittsburgh Sleep Inventory and Brief Quality of Life Questionnaire. Data analysis was performed using Pearson’s correlation coefficient and stepwise multiple regression by SPSS 23. Results: The results indicated that 41.1% and 54.4% of patients with bipolar I disorder experienced low level of sleep quality and QOL, respectively. There was a statistically significant relationship between sleep quality and QOL (r=-0.571, p<0.001), so that low sleep quality has a negative impact on the QOL in these patients. Discussion: Patients with bipolar disorder suffer from sleep disorder affecting their QOL. Therefore, it is suggested that treatment and care interventions be designed and implemented to improve sleep quality and patients’ QOL. Moreover, treatment interventions of bipolar disorder are inseparable from the treatment of sleep disturbance