Objective

Pediatric epilepsy and attention-deficit/hyperactivity disorder (ADHD) present a cumulative vulnerability to youth, particularly in the domains of executive function (EF) and quality of life (QoL). The aim of this study was to explore the relationships between EF and epilepsy-specific QoL in youth with epilepsy (YWE) who also have ADHD.

Methods

Youth with epilepsy aged 5–18 years and caregivers participated in a large multi-site national validation of the PedsQL™ Epilepsy Modules. YWE and their caregivers were asked to complete measures of epilepsy-specific QoL, ADHD symptoms, and EF. Previous ADHD diagnosis was reported by caregivers as well as abstracted from the medical record.

Results

Caregiver and YWE reports of current ADHD symptoms significantly predicted all epilepsy-specific QoL domains. Suboptimal QoL was reported for those YWE whose ADHD symptoms were above the clinical threshold compared to YWE whose ADHD symptoms were within the average range. Results were similar for YWE with a documented ADHD vs no ADHD diagnosis. In addition, poorer metacognition and behavioral regulation EF was associated with lower epilepsy-specific QoL for both YWE with ADHD and without ADHD diagnosis. However, in YWE with ADHD, effect sizes were consistently larger for behavioral regulation compared to metacognition across epilepsy-specific QoL domains, with behavioral regulation accounting for 50% of the variance in each of the EF and mood QoL domains.

Significance

Addressing ADHD symptoms, epilepsy-specific, QoL, and EF as part of routine epilepsy care may promote optimal outcomes for YWE with ADHD as well as relieve burden on the healthcare system.

中文翻译：

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青少年癫痫患者的 ADHD 和癫痫相关 QoL

客观的

小儿癫痫和注意力缺陷/多动障碍 (ADHD) 对年轻人来说是一种累积的脆弱性，特别是在执行功能 (EF) 和生活质量 (QoL) 领域。本研究的目的是探讨 EF 与患有多动症的青少年癫痫 (YWE) 的癫痫特异性 QoL 之间的关系。

方法

5-18 岁的癫痫青少年和护理人员参与了 PedsQL™ 癫痫模块的大型多站点国家验证。YWE 及其护理人员被要求完成癫痫特定 QoL、ADHD 症状和 EF 的测量。先前的 ADHD 诊断由护理人员报告并从病历中提取。

结果

当前 ADHD 症状的看护人和 YWE 报告显着预测了所有癫痫特异性 QoL 域。与 ADHD 症状在平均范围内的 YWE 相比，ADHD 症状高于临床阈值的 YWE 报告的 QoL 次优。有记录的 ADHD 与无 ADHD 诊断的 YWE 的结果相似。此外，对于患有 ADHD 和没有 ADHD 诊断的 YWE，较差的元认知和行为调节 EF 与较低的癫痫特异性 QoL 相关。然而，在患有 ADHD 的 YWE 中，与跨癫痫特异性 QoL 域的元认知相比，行为调节的效应量始终较大，行为调节占 EF 和情绪 QoL 域中每个域的方差的 50%。

意义

解决 ADHD 症状、癫痫特异性、QoL 和 EF 作为常规癫痫护理的一部分可能会促进患有 ADHD 的 YWE 的最佳结果，并减轻医疗保健系统的负担。