EP. 3 Study Limitations of Evaluating Depression in Youth with Epilepsy

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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 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 segment, Wolfe-Christensen and Wagner reflected on several important limitations of the study stemming from the use of a large, multi-site national dataset. While the inclusion of over 400 youth across 30 epilepsy centers strengthened the study’s scope, they noted variability in clinical practices and behavioral assessments across sites posed challenges. The panel also documented that all behavioral data were caregiver-reported, excluding youth self-reports, which may underestimate symptoms, particularly among adolescents who are often better reporters of their mood. Additionally, the wide range of intellectual functioning within the sample and the lack of developmentally normed depression measures for youth with intellectual disabilities further limited assessment precision.

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