LAUSR

OBJECTIVE To determine the short and longer-term impact of sociodemographic disadvantage on the emotional-behavioral status of youth with new-onset epilepsy and their unaffected siblings at the time of diagnosis and the subsequent 3 years. METHODS 312 youth with newly diagnosed epilepsies and 223 unaffected siblings, age 6-16 years, were independently assessed regarding their emotional and behavioral status by their parents and teachers at baseline, at 18 and at 36 months later; and the youth with seizures also completed self-report measures of depression, anxiety and hostility at those three timepoints. A Sociodemographic Disadvantage score was computed for each family (children with newly diagnosed seizures and their siblings) and families were separated out into four categories from most disadvantaged to least disadvantaged. RESULTS In both children and siblings, the least disadvantaged group exhibited the lowest level of neurobehavioral problems; whereas the most disadvantaged group showed a higher level of neurobehavioral problems across all the same behavior metrics. Findings remained stable and significant across all informants (parent, teacher, child) and across all time periods (throughout the 3-year period). Furthermore, both corrected and uncorrected linear regression analyses indicated that disadvantage was a more constant and stable predictor of behavioral and emotional problems over time compared to clinical seizure characteristics and abnormalities in magnetic resonance imaging and electroencephalogram testing. SIGNIFICANCE Sociodemographic disadvantage bears a strong relationship to youth with emotional and behavioral problems both at the time of diagnosis as well as prospectively. The relationship is robust and reflected in reports from multiple informants (parent, teacher, child self-report), evident in siblings as well, and possibly more explanatory than traditional clinical seizure variables. Future studies will be needed to determine if this disadvantage factor is modifiable with early intervention.