Key points interpretation of the consensus guidelines for diagnosis and treatment of anxiety and depression in pediatric and adolescent patients with epilepsy by the International League Against Epilepsy_Journal of Epilepsy

Authors：

LI Fangfang ¹ , ZHANG Xiaofan ¹ ,  YANG Qi ²

1. Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China;
2. Department of Neurology, Songzi People's Hospital, Songzi 434200, China;

Corresponding?author：

YANG Qi, Email: 55861326@qq.com

Keywords：

Anxiety; Depression; Epilepsy; Children; Adolescents; Recommendations

DOI：

10.7507/2096-0247.202606004

Video：

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Abstract Full text Figures/Tables Video References Cited by

The International League Against Epilepsy (ILAE) published the "Consensus on the Diagnosis and Treatment of Anxiety and Depression in Children and Adolescentith Epilepsy" (hereinafter referred to as the ILAE Consensus) in 2024, which was developed based on systematic reviews and the Delphi method, a critical evidence-based framework for clinical practice. This article interprets the ILAE Consensus by focusing on key aspects including assessment and monitoring, screening tools, epilepsy-specific considerations, pychotherapy, pharmacotherapy, and ongoing management. The aim is to offer healthcare professionals a standardized reference for practice, thereby facilitating the early identification and comprehensive management of psychiatric comorbiditieschildren and adolescents with epilepsy.

Citation： LI Fangfang, ZHANG Xiaofan, YANG Qi. Key points interpretation of the consensus guidelines for diagnosis and treatment of anxiety and depression in pediatric and adolescent patients with epilepsy by the International League Against Epilepsy. Journal of Epilepsy, 2026, 12(5): 446-453. doi: 10.7507/2096-0247.202606004 Copy

1.	Karanja SW, Kiburi SK, Kang'Ethe R, et al. Emotional and behavioral problems in children with epilepsy attending the pediatric neurology clinic at a referral hospital in Kenya [J]. Epilepsy Behav, 2021, 114(Pt A): 107477.
2.	Reilly C, Atkinson P, Das KB, et al. Neurobehavioral comorbidities in children with active epilepsy: a population-based study[J]. Pediatrics, 2014, 133(6): e1586-e1593.
3.	Plevin D, Smith N. Assessment and Management of Depression and Anxiety in Children and Adolescents with Epilepsy[J]. Behav Neurol, 2019, 2019: 2571368.
4.	World Health Organization. Comprehensive mental health action plan 2013–2030 [Z]. 2021.
5.	Kieling C, Buchweitz C, Caye A, et al. Worldwide prevalence and disability from mental disorders across childhood and adolescence: evidence from the global burden of disease study[J]. JAMA Psychiatry, 2024, 81(4): 347-356.
6.	Valente KD, Reilly C, Carvalho RM, et al. Consensus-based recommendations for the diagnosis and treatment of anxiety and depression in children and adolescents with epilepsy: A report from the Psychiatric Pediatric Issues Task Force of the International League Against Epilepsy[J]. Epilepsia, 2024, 65(11): 3155-3185.
7.	朱寅杰, 王小姍. 兒童失神癲癇的神經精神共患病研究進展[J]. 臨床神經病學雜志, 2025, 38(4): 311-317.Zhu YJ, Wang XS. Research progress on neuropsychiatric comorbidities in childhood absence epilepsy[J]. Journal of Clinical Neurology, 2025, 38(4): 311-317.
8.	倪晶, 李偉. 兒童癲癇精神合并癥的流行病學特征、危險因素與綜合管理[J]. 東南大學學報 (醫學版), 2025, 44(2): 340-343.Ni J, Li W. Epidemiological characteristics, risk factors and comprehensive management of psychiatric comorbidities in children with epilepsy[J]. Journal of Southeast University (Medical Science Edition), 2025, 44(2): 340-343.
9.	蔡麗飛, 王詩鑌, 邵華, 等. 伴有非自殺性自傷行為的抑郁障礙青少年患者的臨床特征及心理韌性 - 抑郁雙路徑模型調查分析[J]. 實用醫學雜志, 2025, 41(24): 3824-3832.Cai LF, Wang SB, Shao H, et al. Clinical characteristics and resilience-depression dual-path model analysis in adolescents with depressive disorder accompanied by non-suicidal self-injury behavior[J]. J Pract Med, 2025, 41(24): 3824-3832.
10.	董曉杰, 王鵬, 馬俊華, 等. 青少年抑郁癥患者人格特征與非自殺性自傷行為的相關性分析[J]. 實用醫學雜志, 2024, 40(20): 2848-2853.Dong XJ, Wang P, Ma JH, et al. Correlation analysis between personality traits and non-suicidal self-injury in adolescents with depressive disorder[J]. The Journal of Practical Medicine, 2024, 40(20): 2848-2853.
11.	Achenbach TM, Ruffle TM. The Child Behavior Checklist and related forms for assessing behavioral/emotional problems and competencies[J]. Pediatr Rev, 2000, 21(8): 265-271.
12.	Bakhtiari R, Hutchison SM, Iarocci G. How do children and youth with autism spectrum disorder self-report on behavior? A study of the validity indexes on the Behavior Assessment System for Children, Second Edition, self-report of personality[J]. Autism, 2021, 25(4): 1100-1113.
13.	全國兒童行為問題協作組. 全國 22 個省市 26 個單位 24013 名城市在校少年兒童行為問題調查—獨生子女精神衛生問題的調查, 防治和 Achenbach's 兒童行為量表中國標準化[J]. 上海精神醫學, 1992, 1: 47-55.National Collaborative Group for Child Behavioral Problems. A survey on behavioral problems among 24, 013 urban school children from 26 institutions across 22 provinces and municipalities nationwide — Investigation, prevention and treatment of mental health issues in only children and Chinese standardization of Achenbach’s Child Behavior Checklist[J]. Shanghai Archives of Psychiatry, 1992, 1: 47-55.
14.	吳立云, 姚凱南. 嬰幼兒行為檢查表 (CBCL) 西安地區的試用報告[J]. 心理科學, 1993(5): 58-61.Wu LY, Yao KN. Trial report of the Toddler Behavior Checklist (CBCL) in Xi’an area[J]. Journal of Psychological Science, 1993(5): 58-61.
15.	胡煜琦. 中學生版行為評定量表的修訂及基于 PERMA 模式的干預研究 [D]. 江西師范大學, 2024, 碩士學位論文.Hu YQ. Revision of the Behavior Rating Scale for Middle School Students and Intervention Research Based on the PERMA Model [D]. Nanchang: Jiangxi Normal University, 2024. Master’s Thesis.
16.	周新雨, 洪震, 虞培敏, 等. 癲癇伴焦慮診斷治療的中國專家共識[J]. 癲癇雜志, 2018, 4(3): 185-191.Zhou XY, Hong Z, Yu PM, et al. Chinese expert consensus on diagnosis and treatment of epilepsy with comorbid anxiety[J]. Journal of Epilepsy, 2018, 4(3): 185-191.
17.	李勁梅. 癲癇伴抑郁診斷治療的中國專家共識(2022 修訂版)[J]. 癲癇雜志, 2022, 8(6): 488-493.Li JM. Chinese expert consensus on diagnosis and treatment of epilepsy with comorbid depression (2022 revised edition)[J]. Journal of Epilepsy, 2022, 8(6): 488-493.
18.	Cheung AH, Zuckerbrot RA, Jensen PS, et al. Guidelines for adolescent depression in primary care (GLAD-PC): Part II. Treatment and ongoing management [J]. Pediatrics, 2018, 141(3): e20174082.
19.	Zuckerbrot RA, Cheung AH, Jensen PS, et al. Guidelines for adolescent depression in primary care (GLAD-PC): Part I. Practice preparation, identification, assessment, and initial management [J]. Pediatrics, 2018, 141(3): e20174081.
20.	Foy JM, Green CM, Earls MF, et al. Mental health competencies for pediatric practice[J]. pediatrics, 2019, 144(5): e20192757.
21.	Guideline Development Panel for the Treatment of Depressive Disorders. Summary of the clinical practice guideline for the treatment of depression across three age cohorts[J]. Am Psychol, 2022, 77(6): 770-780.
22.	劉文超, 張開慧, 徐小蓮, 等. 青少年癲癇共病焦慮抑郁患者的睡眠特點研究及相關性分析[J]. 癲癇與神經電生理學雜志, 2025, 34(1): 27-32.Liu WC, Zhang KH, Xu XL, et al. Study on sleep characteristics and correlation analysis in adolescents with epilepsy comorbid with anxiety and depression[J]. Journal of Epilepsy and Electroneurophysiology, 2025, 34(1): 27-32.
23.	秦凱芹, 朱立紅. 家庭正向行為支持對學齡前癲癇患兒情緒及行為問題的影響[J]. 癲癇雜志, 2023, 9(5): 375-381.Qin KQ, Zhu LH. Effects of positive behavioral family support on emotional and behavioral problems in preschool children with epilepsy[J]. Journal of Epilepsy, 2023, 9(5): 375-381.
24.	國家衛生健康委員會, 中央宣傳部, 中央網信辦, 等. 健康中國行動—兒童青少年心理健康行動方案(2023—2030 年)[Z]. 2023.National Health Commission of the People’s Republic of China, Publicity Department of the Central Committee of the Communist Party of China, Central Cyberspace Affairs Commission, et al. Healthy china initiative — action plan for mental health of children and adolescents (2023–2030) [Z]. 2023.
25.	World Health Organization. Mental health atlas 2024 [Z]. Geneva: WHO, 2024.
26.	Li F, Cui Y, Li Y, et al. Prevalence of mental disorders in school children and adolescents in China: diagnostic data from detailed clinical assessments of 17, 524 individuals[J]. J Child Psychol Psychiatry, 2022, 63(1): 34-46.
27.	He F, Chen S, Ke X, et al. Training status of child and adolescent psychiatrists in China[J]. Eur Child Adolesc Psychiatry, 2020, 29(1): 83-88.
28.	陳祉妍, 郭菲, 王雅芯. 中國國民心理健康發展報告 (2023-2024) [M]. 北京: 社會科學文獻出版社, 2024.Chen ZY, Guo F, Wang YX. Report on National Mental Health Development in China (2023–2024) [M]. Beijing: Social Sciences Academic Press, 2024.
29.	Barican JL, Yung D, Schwartz C, et al. Prevalence of childhood mental disorders in high-income countries: a systematic review and meta-analysis to inform policymaking[J]. Evid Based Ment Health, 2022, 25(1): 36-44.
30.	Barrett E, Klasen H, Jacobs B, et al. The child and adolescent psychiatry: study of training in Europe (CAP-STATE)[J]. Eur Child Adolesc Psychiatry, 2020, 29(1): 11-27.
31.	Whitney DG, Peterson MD. US National and state-level prevalence of mental health disorders and disparities of mental health care use in children[J]. JAMA Pediatr, 2019, 173(4): 389-391.
32.	Luxton R, Kyriakopoulos M. Depression in children and young people: identification and management NICE guidelines[J]. Arch Dis Child Educ Pract Ed, 2022, 107(1): 36-38.
33.	Walter HJ, Bukstein OG, Abright AR, et al. Clinical practice guideline for the assessment and treatment of children and adolescents with anxiety disorders[J]. J Am Acad Child Adolesc Psychiatry, 2020, 59(10): 1107-1124.
34.	March J, Silva S, Petrycki S, et al. Treatment for adolescents with depression study (TADS) Team. Fluoxetine, cognitive-behavioral therapy, and their combination for adolescents with depression: treatment for adolescents with depression study (TADS) randomized controlled trial [J]. JAMA, 2004, 292(7): 807-820.
35.	Wang Z, Whiteside SPH, Sim L, et al. Comparative effectiveness and safety of cognitive behavioral therapy and pharmacotherapy for childhood anxiety disorders: a systematic review and meta-analysis[J]. JAMA Pediatr, 2017, 171(11): 1049-1056.
36.	亓新華. 醫院 - 家庭聯動式童趣化心理干預聯合延續性護理對癲癇患兒依從性、復發率及不良情緒的影響[J]. 臨床醫學研究與實踐, 2025, 10(33): 145-148.Qi XH. Effects of hospital-family linkage childlike psychological intervention combined with continuous nursing on compliance, recurrence rate and negative emotions in children with epilepsy[J]. Clinical Medical Research and Practice, 2025, 10(33): 145-148.
37.	De Iorgi R, Lomax T, Moreno C, et al. Epilepsy and mental health disorders: current challenges and potential solutions[J]. Br J Psychiatry, 2025, 20: 1-8.

1. Karanja SW, Kiburi SK, Kang'Ethe R, et al. Emotional and behavioral problems in children with epilepsy attending the pediatric neurology clinic at a referral hospital in Kenya [J]. Epilepsy Behav, 2021, 114(Pt A): 107477.
2. Reilly C, Atkinson P, Das KB, et al. Neurobehavioral comorbidities in children with active epilepsy: a population-based study[J]. Pediatrics, 2014, 133(6): e1586-e1593.
3. Plevin D, Smith N. Assessment and Management of Depression and Anxiety in Children and Adolescents with Epilepsy[J]. Behav Neurol, 2019, 2019: 2571368.
4. World Health Organization. Comprehensive mental health action plan 2013–2030 [Z]. 2021.
5. Kieling C, Buchweitz C, Caye A, et al. Worldwide prevalence and disability from mental disorders across childhood and adolescence: evidence from the global burden of disease study[J]. JAMA Psychiatry, 2024, 81(4): 347-356.
6. Valente KD, Reilly C, Carvalho RM, et al. Consensus-based recommendations for the diagnosis and treatment of anxiety and depression in children and adolescents with epilepsy: A report from the Psychiatric Pediatric Issues Task Force of the International League Against Epilepsy[J]. Epilepsia, 2024, 65(11): 3155-3185.
7. 朱寅杰, 王小姍. 兒童失神癲癇的神經精神共患病研究進展[J]. 臨床神經病學雜志, 2025, 38(4): 311-317.Zhu YJ, Wang XS. Research progress on neuropsychiatric comorbidities in childhood absence epilepsy[J]. Journal of Clinical Neurology, 2025, 38(4): 311-317.
8. 倪晶, 李偉. 兒童癲癇精神合并癥的流行病學特征、危險因素與綜合管理[J]. 東南大學學報 (醫學版), 2025, 44(2): 340-343.Ni J, Li W. Epidemiological characteristics, risk factors and comprehensive management of psychiatric comorbidities in children with epilepsy[J]. Journal of Southeast University (Medical Science Edition), 2025, 44(2): 340-343.
9. 蔡麗飛, 王詩鑌, 邵華, 等. 伴有非自殺性自傷行為的抑郁障礙青少年患者的臨床特征及心理韌性 - 抑郁雙路徑模型調查分析[J]. 實用醫學雜志, 2025, 41(24): 3824-3832.Cai LF, Wang SB, Shao H, et al. Clinical characteristics and resilience-depression dual-path model analysis in adolescents with depressive disorder accompanied by non-suicidal self-injury behavior[J]. J Pract Med, 2025, 41(24): 3824-3832.
10. 董曉杰, 王鵬, 馬俊華, 等. 青少年抑郁癥患者人格特征與非自殺性自傷行為的相關性分析[J]. 實用醫學雜志, 2024, 40(20): 2848-2853.Dong XJ, Wang P, Ma JH, et al. Correlation analysis between personality traits and non-suicidal self-injury in adolescents with depressive disorder[J]. The Journal of Practical Medicine, 2024, 40(20): 2848-2853.
11. Achenbach TM, Ruffle TM. The Child Behavior Checklist and related forms for assessing behavioral/emotional problems and competencies[J]. Pediatr Rev, 2000, 21(8): 265-271.
12. Bakhtiari R, Hutchison SM, Iarocci G. How do children and youth with autism spectrum disorder self-report on behavior? A study of the validity indexes on the Behavior Assessment System for Children, Second Edition, self-report of personality[J]. Autism, 2021, 25(4): 1100-1113.
13. 全國兒童行為問題協作組. 全國 22 個省市 26 個單位 24013 名城市在校少年兒童行為問題調查—獨生子女精神衛生問題的調查, 防治和 Achenbach's 兒童行為量表中國標準化[J]. 上海精神醫學, 1992, 1: 47-55.National Collaborative Group for Child Behavioral Problems. A survey on behavioral problems among 24, 013 urban school children from 26 institutions across 22 provinces and municipalities nationwide — Investigation, prevention and treatment of mental health issues in only children and Chinese standardization of Achenbach’s Child Behavior Checklist[J]. Shanghai Archives of Psychiatry, 1992, 1: 47-55.
14. 吳立云, 姚凱南. 嬰幼兒行為檢查表 (CBCL) 西安地區的試用報告[J]. 心理科學, 1993(5): 58-61.Wu LY, Yao KN. Trial report of the Toddler Behavior Checklist (CBCL) in Xi’an area[J]. Journal of Psychological Science, 1993(5): 58-61.
15. 胡煜琦. 中學生版行為評定量表的修訂及基于 PERMA 模式的干預研究 [D]. 江西師范大學, 2024, 碩士學位論文.Hu YQ. Revision of the Behavior Rating Scale for Middle School Students and Intervention Research Based on the PERMA Model [D]. Nanchang: Jiangxi Normal University, 2024. Master’s Thesis.
16. 周新雨, 洪震, 虞培敏, 等. 癲癇伴焦慮診斷治療的中國專家共識[J]. 癲癇雜志, 2018, 4(3): 185-191.Zhou XY, Hong Z, Yu PM, et al. Chinese expert consensus on diagnosis and treatment of epilepsy with comorbid anxiety[J]. Journal of Epilepsy, 2018, 4(3): 185-191.
17. 李勁梅. 癲癇伴抑郁診斷治療的中國專家共識(2022 修訂版)[J]. 癲癇雜志, 2022, 8(6): 488-493.Li JM. Chinese expert consensus on diagnosis and treatment of epilepsy with comorbid depression (2022 revised edition)[J]. Journal of Epilepsy, 2022, 8(6): 488-493.
18. Cheung AH, Zuckerbrot RA, Jensen PS, et al. Guidelines for adolescent depression in primary care (GLAD-PC): Part II. Treatment and ongoing management [J]. Pediatrics, 2018, 141(3): e20174082.
19. Zuckerbrot RA, Cheung AH, Jensen PS, et al. Guidelines for adolescent depression in primary care (GLAD-PC): Part I. Practice preparation, identification, assessment, and initial management [J]. Pediatrics, 2018, 141(3): e20174081.
20. Foy JM, Green CM, Earls MF, et al. Mental health competencies for pediatric practice[J]. pediatrics, 2019, 144(5): e20192757.
21. Guideline Development Panel for the Treatment of Depressive Disorders. Summary of the clinical practice guideline for the treatment of depression across three age cohorts[J]. Am Psychol, 2022, 77(6): 770-780.
22. 劉文超, 張開慧, 徐小蓮, 等. 青少年癲癇共病焦慮抑郁患者的睡眠特點研究及相關性分析[J]. 癲癇與神經電生理學雜志, 2025, 34(1): 27-32.Liu WC, Zhang KH, Xu XL, et al. Study on sleep characteristics and correlation analysis in adolescents with epilepsy comorbid with anxiety and depression[J]. Journal of Epilepsy and Electroneurophysiology, 2025, 34(1): 27-32.
23. 秦凱芹, 朱立紅. 家庭正向行為支持對學齡前癲癇患兒情緒及行為問題的影響[J]. 癲癇雜志, 2023, 9(5): 375-381.Qin KQ, Zhu LH. Effects of positive behavioral family support on emotional and behavioral problems in preschool children with epilepsy[J]. Journal of Epilepsy, 2023, 9(5): 375-381.
24. 國家衛生健康委員會, 中央宣傳部, 中央網信辦, 等. 健康中國行動—兒童青少年心理健康行動方案(2023—2030 年)[Z]. 2023.National Health Commission of the People’s Republic of China, Publicity Department of the Central Committee of the Communist Party of China, Central Cyberspace Affairs Commission, et al. Healthy china initiative — action plan for mental health of children and adolescents (2023–2030) [Z]. 2023.
25. World Health Organization. Mental health atlas 2024 [Z]. Geneva: WHO, 2024.
26. Li F, Cui Y, Li Y, et al. Prevalence of mental disorders in school children and adolescents in China: diagnostic data from detailed clinical assessments of 17, 524 individuals[J]. J Child Psychol Psychiatry, 2022, 63(1): 34-46.
27. He F, Chen S, Ke X, et al. Training status of child and adolescent psychiatrists in China[J]. Eur Child Adolesc Psychiatry, 2020, 29(1): 83-88.
28. 陳祉妍, 郭菲, 王雅芯. 中國國民心理健康發展報告 (2023-2024) [M]. 北京: 社會科學文獻出版社, 2024.Chen ZY, Guo F, Wang YX. Report on National Mental Health Development in China (2023–2024) [M]. Beijing: Social Sciences Academic Press, 2024.
29. Barican JL, Yung D, Schwartz C, et al. Prevalence of childhood mental disorders in high-income countries: a systematic review and meta-analysis to inform policymaking[J]. Evid Based Ment Health, 2022, 25(1): 36-44.
30. Barrett E, Klasen H, Jacobs B, et al. The child and adolescent psychiatry: study of training in Europe (CAP-STATE)[J]. Eur Child Adolesc Psychiatry, 2020, 29(1): 11-27.
31. Whitney DG, Peterson MD. US National and state-level prevalence of mental health disorders and disparities of mental health care use in children[J]. JAMA Pediatr, 2019, 173(4): 389-391.
32. Luxton R, Kyriakopoulos M. Depression in children and young people: identification and management NICE guidelines[J]. Arch Dis Child Educ Pract Ed, 2022, 107(1): 36-38.
33. Walter HJ, Bukstein OG, Abright AR, et al. Clinical practice guideline for the assessment and treatment of children and adolescents with anxiety disorders[J]. J Am Acad Child Adolesc Psychiatry, 2020, 59(10): 1107-1124.
34. March J, Silva S, Petrycki S, et al. Treatment for adolescents with depression study (TADS) Team. Fluoxetine, cognitive-behavioral therapy, and their combination for adolescents with depression: treatment for adolescents with depression study (TADS) randomized controlled trial [J]. JAMA, 2004, 292(7): 807-820.
35. Wang Z, Whiteside SPH, Sim L, et al. Comparative effectiveness and safety of cognitive behavioral therapy and pharmacotherapy for childhood anxiety disorders: a systematic review and meta-analysis[J]. JAMA Pediatr, 2017, 171(11): 1049-1056.
36. 亓新華. 醫院 - 家庭聯動式童趣化心理干預聯合延續性護理對癲癇患兒依從性、復發率及不良情緒的影響[J]. 臨床醫學研究與實踐, 2025, 10(33): 145-148.Qi XH. Effects of hospital-family linkage childlike psychological intervention combined with continuous nursing on compliance, recurrence rate and negative emotions in children with epilepsy[J]. Clinical Medical Research and Practice, 2025, 10(33): 145-148.
37. De Iorgi R, Lomax T, Moreno C, et al. Epilepsy and mental health disorders: current challenges and potential solutions[J]. Br J Psychiatry, 2025, 20: 1-8.

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Key points interpretation of the consensus guidelines for diagnosis and treatment of anxiety and depression in pediatric and adolescent patients with epilepsy by the International League Against Epilepsy

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