RESUMO
OBJECTIVE: To evaluate prevalence of psychiatric comorbidities in children with epilepsy (CWE) and to assess their impact on quality of life (QOL). METHODS: All CWE with normal Intelligence Quotient (IQ) were assessed using the Revised Child Anxiety and Depression Scale (RCADS) for anxiety and depression, and Strengths and Difficulties (SDQ) Questionnaire for behavioral and emotional problems. QOL in Children with Epilepsy (QOLCE-31) scale was used to assess the Quality of Life at enrolment and was repeated again after appropriate intervention for comorbidities at 3 months. RESULTS: It was found that 22 (24.4%), 18 (20.0%), 35 (38.9%), 32 (35.56), 26 (28.89), 12 (13.34) children met the clinical threshold for social phobia, major depression, generalized anxiety, separation anxiety, conduct problem and peer problem respectively. After appropriate intervention for the co-morbidities, improvement was noted in the quality of life. CONCLUSION: Psychiatric co-morbidities are common in children with epilepsy and these contribute to the poor quality of life.
RESUMO
Transcranial direct current stimulation (tDCS), a non-invasive, neuromodulatory technique, is being increasingly applied to several psychiatric disorders. In this study, we describe the side-effect profile of repeated tDCS sessions (N = 2005) that were administered to 171 patients (156 adults and 15 adolescents) with different psychiatric disorders [schizophrenia [N = 109], obsessive-compulsive disorder [N = 28], alcohol dependence syndrome [N = 13], mild cognitive impairment [N = 10], depression [N = 6], dementia [N = 2] and other disorders [N = 3]]. tDCS was administered at a constant current strength of 2 mA with additional ramp-up and ramp-down phase of 20 s each at the beginning and end of the session, respectively. Other tDCS protocol parameters were: schizophrenia and obsessive-compulsive disorder: 5-days of twice-daily 20-min sessions with an inter-session interval of 3-h; Mild cognitive impairment/dementia and alcohol dependence syndrome: at least 5-days of once-daily 20-min session; Depression: 10-days of once-daily 30 min session. At the end of each tDCS session, any adverse event observed by the administrator and/or reported by the patient was systematically assessed using a comprehensive questionnaire. The commonly reported adverse events during tDCS included burning sensations (16.2%), skin redness (12.3%), scalp pain (10.1%), itching (6.7%), and tingling (6.3%). Most of the adverse events were noted to be mild, transient and well-tolerated. In summary, our observations suggest that tDCS is a safe mode for therapeutic non-invasive neuromodulation in psychiatric disorders in adults as well as the adolescent population.