Behavioural Co-morbidities in Children With Epilepsy Using Strengths and Difficulties Questionnaire: A Case-Control Study From Central India

Background Childhood epilepsy carries a profound, often overlooked burden of behavioural comorbidities, particularly in resource-limited settings where these hidden challenges remain poorly characterized. Methods This observational case-control study from central rural India enrolled 126 children (aged 2-13 years): 63 with epilepsy and 63 healthy controls. Behavioural domains were quantified using the validated parent-reported Strengths and Difficulties Questionnaire (SDQ). Results Children with epilepsy (CWE) exhibited a striking increase in behavioural issues post-onset (49.2%) vs their pre-onset baseline (17.5%; P = .0001). Compared to controls, CWE had significantly elevated high-risk scores ( P < .001) for conduct problems, hyperactivity, peer problems, and total difficulties. Interestingly, emotional symptoms showed no significant difference. Conclusion The substantial neuro-behavioural burden in CWE necessitates a critical shift toward integrated care. Routine SDQ screening is vital for early detection and psychiatric management especially in resource-limited regions.