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      The psychosocial impact of COVID-19 within the first six months of the pandemic on youth with epilepsy and their caregivers

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          Abstract

          Objectives

          We assessed the impact of COVID-19 on children with epilepsy and their families, focusing on epilepsy management, family routines, learning, and adherence to Centers for Disease Control and Prevention (CDC) pandemic guidelines (e.g., social distancing, mask wearing) within the first six months of the pandemic. Group differences in COVID-19 impact on families were also examined based on race and ethnicity, being medically and/or geographically underserved, and insurance status.

          Methods

          Participants ( n = 131) included children with epilepsy and their families from two clinical trials. The Impact of COVID-19 on Pediatric Epilepsy Management (ICPEM) measure was developed and administered to caregivers online from April 2020 to September 2020 across four large pediatric hospitals. Administration of the ICPEM occurred both during routine study assessments and an additional acute time point to obtain information early in the pandemic (e.g., April and May 2020). Descriptive statistics and t-tests were used for analyses.

          Results

          Data indicate minor to moderate impact of COVID-19 on pediatric epilepsy management. Caregivers of children with epilepsy reported the most impact on education and social functioning. Adherence to CDC guidelines was reported to be high. Those having public insurance reported greater difficulties obtaining daily anti-seizure medications compared to those with private insurance.

          Conclusions

          This study presents important initial data regarding the impact of COVID-19 epilepsy management and daily functioning in children with epilepsy and their families. While the acute impact of COVID-19 restrictions appear to be mild to moderate, it is unclear what the long-term impact of the pandemic will be on families of children with epilepsy.

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          Most cited references37

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          Treatment Outcomes in Patients With Newly Diagnosed Epilepsy Treated With Established and New Antiepileptic Drugs

          A study published in 2000 showed that more than one-third of adults with epilepsy have inadequate control of seizures with antiepileptic drugs (AEDs). This study evaluates overall treatment outcomes in light of the introduction of more than 1 dozen new AEDs in the past 2 decades.
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            Keeping people with epilepsy safe during the COVID-19 pandemic

            Objectives To provide information on the effect of the coronavirus disease of 2019 (COVID-19) pandemic on people with epilepsy and provide consensus recommendations on how to provide the best possible care for people with epilepsy while avoiding visits to urgent care facilities and hospitalizations during the novel coronavirus pandemic. Methods The authors developed consensus statements in 2 sections. The first was “How should we/clinicians modify our clinical care pathway for people with epilepsy during the COVID-19 pandemic?” The second was “What general advice should we give to people with epilepsy during this crisis? The authors individually scored statements on a scale of −10 (strongly disagree) to +10 (strongly agree). Five of 11 recommendations for physicians and 3/5 recommendations for individuals/families were rated by all the authors as 7 or above (strongly agree) on the first round of rating. Subsequently, a teleconference was held where statements for which there was a lack of strong consensus were revised. Results After revision, all consensus recommendations received a score of 7 or above. The recommendations focus on administration of as much care as possible at home to keep people with epilepsy out of health care facilities, where they are likely to encounter COVID-19 (including strategies for rescue therapy), as well as minimization of risk of seizure exacerbation through adherence, and through ensuring a regular supply of medication. We also provide helpful links to additional helpful information for people with epilepsy and health providers. Conclusion These recommendations may help health care professionals provide optimal care to people with epilepsy during the coronavirus pandemic.
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              Severe psychological distress among patients with epilepsy during the COVID‐19 outbreak in southwest China

              Abstract Objective To compare the severity of psychological distress between patients with epilepsy and healthy controls during the COVID‐19 outbreak in southwest China, as well as identify potential risk factors of severe psychological distress among patients with epilepsy. Methods This cross‐sectional case‐control study examined a consecutive sample of patients older than 15 years treated at the epilepsy center of West China Hospital between February 1 and February 29, 2020. As controls, sex‐ and age‐matched healthy visitors of inpatients (unrelated to the patients) were also enrolled during the same period. Data on demographics and attention paid to COVID‐19 were collected by online questionnaire, data on epilepsy features were collected from electronic medical records, and psychological distress was evaluated using the 6‐item Kessler Psychological Distress Scale (K‐6). Potential risk factors of severe psychological distress were identified using multivariate logistic regression. Results The 252 patients and 252 controls in this study were similar along all demographic variables except family income. Patients with epilepsy showed significantly higher K‐6 scores than healthy controls and spent significantly more time following the COVID‐19 outbreak (both P  12; both P ≤ .001). Multivariate logistic regression identified two independent predictors of severe psychological distress: time spent paying attention to COVID‐19 (odds ratio [OR] = 1.172, 95% confidence interval [CI] = 1.073‐1.280) and diagnosis of drug‐resistant epilepsy (OR = 0.283, 95% CI = 0.128‐0.623). Significance During public health outbreaks, clinicians and caregivers should focus not only on seizure control but also on mental health of patients with epilepsy, especially those with drug‐resistant epilepsy. K‐6 scores > 12 indicate severe psychological distress. This may mean, for example, encouraging patients to engage in other activities instead of excessively following media coverage of the outbreak.
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                Author and article information

                Journal
                Epilepsy Behav
                Epilepsy Behav
                Epilepsy & Behavior
                Elsevier Inc.
                1525-5050
                1525-5069
                12 February 2021
                April 2021
                12 February 2021
                : 117
                : 107855
                Affiliations
                [a ]Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, 3333 Burnet Ave., Cincinnati, OH 45229, United States
                [b ]University of Cincinnati, College of Medicine, United States
                [c ]Nationwide Children’s Hospital, 700 Children’s Drive, Near East Office Building, 3rd Floor, Columbus, OH 43205, United States
                [d ]The Ohio State, Department of Pediatrics, 700 Children’s Drive, Near East Office Building, 3rd Floor, Columbus, OH 43205, United States
                [e ]College of Nursing, Medical University of South Carolina, Colcock Hall, 19 Bee St, MSC 002, Charleston, SC 29425, United States
                [f ]Department of Pediatric Psychology, Children’s Hospital of Orange County, 1120 W La Veta Ave, Ste 470, Orange, CA 92868, United States
                [g ]College of Education, University of Florida, 2423 Normal Hall (2-206), PO Box 117048, Gainesville, FL 32611, United States
                Author notes
                [* ]Corresponding author at: Cincinnati Children’s Hospital Medical Center, Division of Behavioral Medicine and Clinical Psychology, Center for Treatment Adherence and Self-Management, University of Cincinnati, College of Medicine, 3333 Burnet Ave. MLC 7039, Cincinnati, OH 45229, United States.
                Article
                S1525-5050(21)00089-5 107855
                10.1016/j.yebeh.2021.107855
                8035246
                33636530
                30880362-a475-413e-a118-d200181801ae
                © 2021 Elsevier Inc. All rights reserved.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 28 December 2020
                : 9 February 2021
                : 9 February 2021
                Categories
                Article

                Clinical Psychology & Psychiatry
                pandemic,adjustment,children,seizures,distance learning,self-management

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