School performance and psychiatric comorbidity in childhood absence epilepsy: A Danish cohort study

Magnus Spangsberg Boesen*, Malene Landbo Børresen, Søren Kirchhoff Christensen, Amalie Wandel Klein-Petersen, Sahla El Mahdaoui, Malini Vendela Sagar, Emilie Schou, Anna Korsgaard Eltvedt, Melita Cacic Hribljan, Alfred Peter Born, Peter Vilhelm Uldall, Lau Caspar Thygesen, Maria Jose Miranda

*Corresponding author for this work
1 Citation (Scopus)


The aim was to determine school performance and psychiatric comorbidity in children with childhood absence epilepsy (CAE). We reviewed the medical records in children with ICD-10 codes for idiopathic generalized epilepsy before 18 years of age, and pediatric neurologists confirmed the International League Against Epilepsy criteria for CAE were met. Control groups were the general pediatric population or children with non-neurological chronic disease. Outcomes were from nationwide and population-based registers on school performance and psychiatric comorbidity. We compared the mean grade point average using linear regression and estimated hazard ratios (HR) using Cox regression for the other outcomes. Analyses were adjusted for the child's sex, and year of birth, and parental highest education, receipt of cash benefits or early disability pension. We included 114 children with CAE with a median age at onset of 5.9 years (interquartile range = 4.5-7.3 years). Compared with both population controls and non-neurological chronically ill children, children with CAE had increased hazard of special needs education (HR = 2.7, 95% confidence interval (CI) = 1.8-4.1, p < 0.0001), lower grade point average at 9th grade by 1.7 grade points (95% CI = -2.5 to -1.0, p < 0.001), increased ADHD medicine use (HR = 4.4, 95% CI = 2.7-7.2, p < 0.001), increased sleep medicine use (HR 2.7, 95% CI = 1.7-4.3, p < 0.001), and increased psychiatry visits (HR = 2.1; 95% CI = 1.1-4.0; p = 0.03). In conclusion, children with CAE have increased psychiatric comorbidity and a considerable proportion of these children receive special needs education in primary/secondary school, albeit insufficient to normalize their considerably lower grade point average in the 9th grade.

Original languageEnglish
JournalEuropean journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society
Pages (from-to)75-81
Number of pages7
Publication statusPublished - Jan 2023


  • Child
  • Child, Preschool
  • Cohort Studies
  • Comorbidity
  • Denmark/epidemiology
  • Epilepsy, Absence/epidemiology
  • Epilepsy, Generalized
  • Humans
  • ADHD
  • Prognosis
  • Psychiatric comorbidity
  • Childhood absence epilepsy
  • School


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