OBJECTIVE Youth with temporal lobe epilepsy (TLE) are at increased risk of depressive features and diminished health-related quality of life (HRQOL). To assist in the development of future behavioral interventions for youth with TLE, the current study explored potential pathways by which executive functioning (EF) and depressive features impinge upon HRQOL in the context of psychosocial and seizure-specific factors. METHODS Data included parental ratings on the Behavior Assessment System for Children (BASC-2), Behavior Rating Inventory of Executive Function (BRIEF), and the Quality of Life in Childhood Epilepsy (QOLCE) questionnaires for 82 children (Age = 11.99, SD = 3.80) with TLE. Observed path analysis was used to simultaneously investigate the determinants of HRQOL in pediatric TLE. Indirect effects were evaluated with bootstrap analyses. RESULTS Both executive dysfunction and depressive features were negatively linked to child HRQOL, and, furthermore, EF and HRQOL were indirectly connected by depressive features. In addition, depressive features were linked to lower EF, current antiepileptic drug (AED) regimen, and the presence of hippocampal sclerosis. Diminished EF was linked to parental psychiatric history and family stress; EF mediated the relationship of parental psychiatric history and family stress on both depressive features and diminished HRQOL. Finally, a more complicated AED regimen and higher HRQOL were indirectly connected by depressive features. CONCLUSION This study underscores the importance of child depressive features and EF along with environmental and epilepsy-specific factors on HRQOL in pediatric TLE.

中文翻译：

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执行功能和抑郁情绪独立地破坏小儿颞叶癫痫的健康相关生活质量

目标 患有颞叶癫痫 (TLE) 的青少年出现抑郁特征和健康相关生活质量 (HRQOL) 的风险增加。为协助为患有 TLE 的青少年制定未来的行为干预措施，本研究探索了在心理社会和癫痫特定因素的背景下，执行功能 (EF) 和抑郁特征影响 HRQOL 的潜在途径。方法 数据包括父母对儿童行为评估系统 (BASC-2)、执行功能行为评估量表 (BRIEF) 和儿童癫痫生活质量 (QOLCE) 问卷的评分，这些问卷对 82 名儿童（年龄 = 11.99，SD = 3.80) 与 TLE。观察到的路径分析用于同时调查儿科 TLE 中 HRQOL 的决定因素。间接影响通过自举分析进行评估。结果 执行功能障碍和抑郁特征均与儿童 HRQOL 呈负相关，此外，EF 和 HRQOL 与抑郁特征间接相关。此外，抑郁特征与较低的 EF、当前的抗癫痫药物 (AED) 方案和海马硬化的存在有关。EF 降低与父母的精神病史和家庭压力有关；EF 介导了父母精神病史和家庭压力对抑郁特征和 HRQOL 降低的关系。最后，更复杂的 AED 方案和更高的 HRQOL 与抑郁特征间接相关。结论 本研究强调了儿童抑郁特征和 EF 以及环境和癫痫特异性因素对小儿 TLE 患者 HRQOL 的重要性。