Predictors of behavioral dysregulation and social dysfunction in pediatric patients with epilepsy and obesity: Developmental timing matters

Childhood obesity has been associated with greater risks of psychopathology, including externalizing behaviors and social dysfunction. However, there has been limited research on the effect of obesity on psychosocial functioning among pediatric patients with epilepsy. Accordingly, this study aimed to examine the association between overweight/obesity and behavioral and social functioning among pediatric patients with epilepsy, as function of their developmental status. We completed a retrospective chart review of data (seizure factors, intellectual functioning, caregiver ratings of aggression/defiance and social problems, sex- and age-adjusted body mass index (BMI) percentile) from 30 school-age children and 30 adolescents with epilepsy evaluated through our institute. Body mass index percentile and overweight/obesity status were not associated with seizure variables. Despite controlling for intellectual functioning, overweight/obesity was associated with greater aggression/defiance among child patients but not adolescents. In contrast, adolescence, but not weight status, was associated with social dysfunction. In brief, while early interventions focused on behavior and weight management among children with epilepsy may mitigate risk of aggression and oppositional behavior, among adolescent patients, therapies directed towards promoting interpersonal skills, sense of social competency, and expansion of social support system may reduce psychosocial maladjustment. Findings highlight need to understand the developmental effects of common medical comorbidities on neurobehavioral functioning among youth with epilepsy.

Keywords: Aggression; Epilepsy; Pediatric obesity; Psychosocial behavior; Social functioning.