Electronic Thesis and Dissertation Repository

Thesis Format

Monograph

Degree

Master of Science

Program

Epidemiology and Biostatistics

Supervisor

Speechley, Kathy N.

Abstract

This study described anxiety symptoms in AYA 10 years after epilepsy diagnosis and assessed the association between family characteristics and long-term anxiety symptoms controlling for parent, clinical and child demographic characteristics. Data were from a multi-centre prospective study of children with new-onset epilepsy. Ten years after diagnosis, 33% scored above the cut-off for clinically significant anxiety symptoms. The mean anxiety z-score was similar to that previously reported in the US population of the same age and sex. Multiple linear regression analyses showed that family characteristics at the 10-year follow-up and at diagnosis were not independently associated with long-term anxiety symptoms. Five-year seizure freedom was independently associated with long-term anxiety symptoms. These findings suggest that the long-term outcome for childhood-onset epilepsy in terms of anxiety symptoms is similar to normative population data and there is a subset of AYA experiencing anxiety symptoms that are worthy of attention.

Summary for Lay Audience

Anxiety symptoms are among the most common mental health symptoms experienced by children with epilepsy and contribute to poorer health-related quality of life. Current literature provides evidence that the family environment plays an important role in mitigating psychiatric symptoms such as anxiety symptoms in children and adolescents with epilepsy. Little is known, however, about the prevalence of anxiety in the long-term as those with childhood-onset epilepsy become adolescents and young adults (AYA). The aims of this thesis were: 1) To describe anxiety symptoms in AYA 10 years after epilepsy diagnosis and 2) to assess the association between family characteristics and anxiety symptoms 10 years after epilepsy diagnosis to identify potentially modifiable family characteristics early in the course of epilepsy. Data for this thesis were from a multicenter prospective cohort study that followed children with newly diagnosed epilepsy and their families for 10 years after diagnosis. The majority of AYA in our study did not experience elevated anxiety symptoms, but about one-third reported experiencing anxiety symptoms 10 years after epilepsy diagnosis. AYA who had not been seizure-free for at least five years, were more likely to experience elevated anxiety symptoms. These findings suggest that the long-term outcome for childhood-onset epilepsy in terms of anxiety symptoms is generally positive overall but a subgroup of these AYA with clinically significant anxiety symptoms warrant attention.

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