Wagstaff, Amalia Sarah; (2025) Depression and Anxiety in Childhood Epilepsy: The Role of Intellectual Disabilities and Autism. Doctoral thesis (Ph.D), UCL (University College London).

Text Wagstaff_10212906_thesis.pdf Access restricted to UCL open access staff until 1 September 2026. Download (2MB)

Abstract

Background: Children and young people (CYP) with epilepsy have a high prevalence of depression and anxiety in studies that have predominantly used structured diagnostic interviews or screening tools. However, little is known about the healthcare-recorded rate of these internalising mental health disorders (IMHDs), despite identification being a necessary step towards receiving evidence-based treatment. Evidence is particularly limited for CYP with epilepsy who have intellectual disability (ID) or are autistic, despite the high prevalence of these neurodevelopmental disabilities in epilepsy and their association with IMHDs. / / Methods: Using English primary-care records (Clinical Practice Research Datalink GOLD) linked with hospital data (Hospital Episode Statistics Admitted Patient Care), CYP aged 7–17 years with epilepsy were matched to peers without epilepsy (1:30) and those with asthma (1:10), based on age and calendar year between January 2015 and December 2019. Incidence rate ratios (IRRs) were estimated using Poisson regression, adjusted for age, sex, and socioeconomic status, and stratified by autism and/or ID. / / Results: 1,821 CYP with epilepsy were matched to 56,910 peers without epilepsy and 18,627 with asthma. IMHD incidence was higher in epilepsy compared to peers without epilepsy (IRR=1.57, 95% CI 1.25–1.95) but not significantly different from those with asthma. Among CYP with epilepsy, autistic CYP without ID (6.8%) had significantly higher IMHD incidence than peers without epilepsy, autism, or ID (IRR=4.14, 95% CI 2.15–7.13) and those with asthma without epilepsy, autism, or ID (IRR=3.12, 95% CI 1.61–5.39). Among CYP epilepsy those with ID (21.1%) had IMHD rates not significantly different from their reference groups. / / Discussion: Findings may reflect the general vulnerability to IMHDs associated with physical health conditions, specific heightened risk among autistic CYP, and possible under recognition of IMHDs in CYP with ID. Integrating physical and mental health services and considering co-occurring neurodevelopmental disabilities on IMHD risk should be priorities in epilepsy management.

Download activity - last month

Export as JSONCSVXML

Download activity - last 12 months

Export as CSVXMLJSON

Downloads by country - last 12 months

Export as JSONXMLCSV

Archive Staff Only

View Item