Elsevier

Seizure

Volume 60, August 2018, Pages 96-104
Seizure

Theory of Mind and social competence in children and adolescents with genetic generalised epilepsy (GGE): Relationships to epilepsy severity and anti-epileptic drugs

https://doi.org/10.1016/j.seizure.2018.06.015Get rights and content
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Highlights

  • Children with GGE have impaired cognitive and affective Theory of Mind (ToM).

  • These ToM impairments are associated with poor social competence in everyday life.

  • Higher daily dosage of valproate is associated with poorer affective ToM.

  • Higher daily dosages of ethosuximide and lamotrigine relate to lower social competence.

  • Greater epilepsy severity on the GASE is a risk factor for decreased social competence.

Abstract

Purpose

This study aimed to examine Theory of Mind (ToM) and social competence in children and adolescents with genetic generalised epilepsy (GGE), and explore how they relate to neurocognitive and epilepsy variables.

Methods

Twenty-two children and adolescents with GGE (8–16 years old) and 22 typically developing controls completed two behavioural tasks (faux-pas, strange stories) assessing cognitive and affective ToM, and a battery of standardised neuropsychological tests. Parents completed questionnaires assessing ToM and social competence. Neurologists completed the Global Assessment Severity of Epilepsy (GASE) scale to measure of epilepsy severity.

Results

Children and adolescents with GGE were impaired in both cognitive and affective ToM, and had reduced social competence compared to controls, which was not attributable to low intellectual functioning or impaired executive skills (working memory, inhibition). Lower ToM correlated with reduced social competence in children and adolescents with GGE. Clinical variables identified included: (i) higher daily dosage of valproate, which was correlated with reduced affective ToM, (ii) higher daily dosages of ethosuximide and lamotrigine, which were correlated with reduced social competence, and (iii) overall epilepsy severity on the GASE, which was correlated with reduced social competence.

Conclusions

Our study revealed cognitive and affective ToM impairments in children and adolescents with GGE, which correlated with everyday social problems. Moreover, higher dosages of commonly prescribed anti-epileptic drugs and overall epilepsy severity were related to ToM impairments and social competence problems. Although preliminary, these findings provide critical information for detection and screening procedures for social difficulties in children and adolescents with GGE, which are currently lacking.

Keywords

Mentalising
Seizure
Childhood
Medication

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