Association of behavioral problems and health-related quality of life in children with epilepsy

OBJECTIVE: In this study we investigated whether children with epilepsy (CWE) and behavioral problems score lower in health-related quality of life (HRQoL) measures compared to CWE with no behavioral problems. METHODS: We recruited 151 patients aged 3-17 years with epilepsy. Behavior was evaluated using the Child behavior checklist [1]. HRQoL of life was measured using the German version of KINDL questionnaire comprising both child report (from age of 3 ongoing) and parent report. The means and difference of means of KINDL scores [2] of the two groups were compared. RESULTS: 151 pediatric patients with epilepsy and their parents or caregivers were included. 37% of children of the cohort had CBCL scores indicating behavioral problems. CWE with behavioral problems experienced reduced total HRQoL scores according to their parents and caregivers (difference mean ± sd, Z-score, adjusted p-value: 11,5 ± 1,6; -6,085; <0,001). This was also true, though to a lesser extent, for self-reports. CBCL subcategories revealed that CWE with 'internal behavioral problems' experience reduced total HRLQoL-scores according to self-reports and parent-reports. CWE with 'external behavioral problems' experience reduced total HRLQoL-scores only according to the parents' reports. SIGNIFICANCE: CWE with behavioral problems score lower in HRQOL-parameters of daily life. This study underlines the importance of evaluation of behavioral problems in CWE.