Review Family factors and psychopathology in children with epilepsy: A literature review Roos Rodenburg a, * , Anne Marie Meijer a , Maja Dekovic ´ b , Albert P. Aldenkamp c a Department of Educational Studies, University of Amsterdam, Amsterdam, The Netherlands b Department of Child and Adolescent Studies, Utrecht University, Utrecht, The Netherlands c Department of Neurology, University Hospital Maastricht, and Department of Behavioral Sciences, Epilepsy Center Kempenhaeghe, The Netherlands Received 13 January 2005; revised 1 March 2005; accepted 1 March 2005 Abstract Purpose: From a social interactional and ecological framework, studies were reviewed that (1) compared family factors in chil- dren with epilepsy with those in children from normative groups, healthy children, children with a chronic illness, or siblings; and (2) examined the relationship between distinct family factors and child psychopathology. Results: Compared with control groups, families with a child with epilepsy generally fare worse on the whole range of family factors, indicating lower parent–child relationship quality, more depression in mothers, and problems with family functioning. Sig- nificant associations were apparent between distinct family factors, especially parental psychological control, parental attributions about epilepsy, and family membersÕ satisfaction with family relationships, and psychopathology in children with epilepsy. Conclusion: Future childhood epilepsy research might benefit from the examination of the simultaneous contribution of distinct family factors to child psychopathology, within a broad multifactorial framework that also includes neurological and medication factors. Ó 2005 Elsevier Inc. All rights reserved. Keywords: Pediatric epilepsy; Family factors; Child psychopathology 1. Introduction Epilepsy is the most common neurological disorder in childhood. The prevalence rate of epilepsy in children is about 0.5% [1]. Approximately 50% of the epilepsies have their onset before the age of 5 years, and 75% have their onset before the age of 20 years [2]. There is ample empirical evidence that children with epilepsy are at in- creased risk for psychopathology. The epidemiological Isle of Wight studies that evaluated a broad range of educational, psychiatric, and physical disorders in rela- tion to behavioral and educational outcomes [3] found that 28.6% of the children with uncomplicated epilepsy had psychiatric disturbances compared with 6.6% of the children from the general population [4]. More re- cently, the epidemiological study of McDermott et al. [5] showed that children with epilepsy are at 4.7 times greater risk for psychopathology than children from the general population. A recent meta-analysis on psy- chopathology in children with epilepsy revealed that children with epilepsy are especially at high risk for internalizing behavior problems (e.g., depression) and attention problems [6]. Several factors that characterize epilepsy (such as neurological dysfunction and the use of medication) are supposed to contribute to psychopathology [7–9]. Neurological dysfunction has been assumed to be the www.elsevier.com/locate/yebeh Epilepsy & Behavior 6 (2005) 488–503 1525-5050/$ - see front matter Ó 2005 Elsevier Inc. All rights reserved. doi:10.1016/j.yebeh.2005.03.006 * Corresponding author: University of Amsterdam, Faculty of Social and Behavioral Sciences, Department of Educational Studies, Wibaut- straat 4, 1090 GE Amsterdam, The Netherlands. Fax: +31 20 5251200. E-mail address: H.R.Rodenburg@uva.nl (R. Rodenburg).