Psychosocial experiences are as important as medical factors in influencing the psychological functioning of children with epilepsy

Epilepsy can profoundly influence children's psychological functioning, yet the contextual factors shaping this experience remain insufficiently understood. Using data from 104 children with epilepsy, their parents, homeroom teachers, and 1829 classmates, this study examined factors affecting children's psychological functioning. A range of diagnostic, psychological, and social variables were assessed, and structural equation modeling was used to analyze relationships. The results showed that both epilepsy-related factors (presence of comorbidities, non-verbal intelligence, seizure freedom, and number of antiepileptic medications) and social influences significantly contributed to psychological functioning. Key social influences linked to the school environment included teacher support and attitudes, classmates' awareness of the child's epilepsy, stigma among classmates, and the child's sociometric position. On the parental side, a significant role was played by parental depression and discrepancies between parent and child quality-of-life assessments. Notably, social influences were as impactful as medical factors, underscoring the need for holistic, multi-level interventions.