EP. 2 Assessing Depressive Symptoms in Children with Epilepsy and Lower IQ

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A 2025 multi-site study published in Epilepsy & Behavior aimed to examine depressive symptoms in children and youth with epilepsy (CYE) who completed measures of emotional and behavioral functioning as part of a pre-surgical neuropsychological evaluation. All told, results revealed that CYE are at a higher risk of experiencing depressive symptoms, especially those with temporal lobe epilepsy (TLE). Findings also indicated that other seizure and sociodemographic variables did not increase risk or resilience, calling for depression screening during routine epilepsy care, including for those CYE with low IQ.

To further understand the clinical relevance of these results, NeurologyLive^® facilitated a discussion with 3 of the study authors: Shannon Brothers, PhD, Cortney Wolfe-Christensen, PhD, and Janelle Wagner, PhD. Brothers is a pediatric epilepsy psychologist at Cincinnati Children's Hospital Medical Center, Wagner is a pediatric psychologist at Medical University of South Carolina, and Wolfe-Christensen is a pediatric psychologist at Children’s Medical Center in Fort Worth, Texas. Throughout the roundtable, each clinician provided insight regarding the recent publication and its clinical implications.

In this second episode, Brothers and Wolfe-Christensen emphasized the critical need to assess and treat depressive symptoms in youth with epilepsy across the full spectrum of cognitive functioning. They highlight how children and adolescents with lower IQs have historically been excluded from research and clinical screening due to limitations in self-report measures, resulting in a substantial portion of the population being overlooked. Drawing on data showing that nearly one-third of their sample had an IQ below 70, the discussion underscores the heightened prevalence of cognitive impairment within refractory epilepsy populations. All in all, the clinicians stressed that current assessment tools are not well suited for these patients, contributing to gaps in intervention, limited behavioral health resources, and unaddressed impacts on health-related quality of life.

REFERENCES
1. Brothers S., Wolfe-Christensen C., Loblein H., et al. Depressive symptoms in youth with refractory epilepsy: Exploration of seizure, sociodemographic and cognitive factors. Epilepsy & Behavior. 2025;Volume 171:110608. DOI: 10.1016/j.yebeh.2025.110608