ADHD-related symptoms, emotional/behavioral problems, and physical conditions in Taiwanese children with epilepsy

Fang Ju Tsai, Shu Tsen Liu, Chi Mei Lee, Wang Tso Lee, Pi Chuan Fan, Wei Sheng Lin, Yen Nan Chiu, Susan Shur Fen Gau

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


Background/Purpose: Little is known about whether Asian children with epilepsy have more attention-deficit hyperactivity disorder (ADHD)-related symptoms, emotional/ behavioral problems, and physical conditions compared with those described in Western studies. The authors investigated the rates of ADHD-related symptoms, emotional/behavioral problems, and physical conditions among pediatric patients with epilepsy. Methods: We recruited 61 patients with epilepsy, aged 6-16 years, and 122 age-, sex-, and parental education-matched school controls. Data on demographics, parental reports on the Child Behavior Checklist (CBCL) and Swanson, Nolan, and Pelham, version IV scale (SNAP-IV), and medical records were collected. Results: The average full-scale intelligence quotient of the case group was 95.8. There were 11 (18.0%), 7 (11.5%), 26 (42.6%), and 26 (42.6%) of children with epilepsy ever clinically diagnosed with developmental delay, overt ADHD symptoms, allergies reported by physicians, and behavior problems measured by the CBCL, respectively. Those children with epilepsy had more severe ADHD-related symptoms and a wider range of emotional/behavioral problems than controls (Cohen's d 0.36-0.80). The rate of potential cases of ADHD among children with epilepsy was 24.6%. A history of developmental delay predicted ADHD- related symptoms and internalizing and externalizing problems. Among children with epilepsy, a longer duration of treatment with antiepileptic drugs predicted externalizing problems, and an earlier onset of epilepsy predicted inattention and hyperactivity/impulsivity. Conclusion: Our findings imply that clinicians should assess physical and emotional/behavioral problems among children with epilepsy in order to provide interventions to offset possible adverse psychiatric outcomes.

Original languageEnglish (US)
Pages (from-to)396-405
Number of pages10
JournalJournal of the Formosan Medical Association
Issue number7
StatePublished - Jul 2013
Externally publishedYes

Bibliographical note

Funding Information:
This study was supported by grants from National Taiwan University Hospital ( NTUH96-S558 ), and National Health Research Institute ( NHRI-EX95-9407PC , NHRI-EX96-9407PC ).


  • Attention-deficit hyperactivity disorder
  • Developmental delay
  • Epilepsy
  • Externalizing problems
  • Internalizing problems


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