Development and Adaptive function of pediatric patients with neurological disorders on ketogenic diet and Caregivers’ psychological stress

Background:
Family members should bear caregiving responsibility with its accompanying stress. This study aimed to investigate function of pediatric patients with neurological disorders on Ketogenic Diet (KD) and their caregivers’s psychological stress.

Methods :
The assessments for 40 caregivers and pediatric patients with neurological disorders including epilepsy were administered and analyzed, between 2015 and 2018 at the pediatric clinics of the Severance Children’s Hospital in South Korea. The neurodevelopmental data of pediatric patients were including developmental quotient/ intellectual quotient, the level of adaptive function and clinical variables such seizure-related as age of onset, lead time to KD start. Additionally the caregivers were administered psychological assessment rated Minnesota Multiphasic Personality Inventory-2, Beck Depression Index-II, State-Trait Anxiety Inventory, Parenting Stress Index .

Results:
A review on clinical variables such KD-related and seizure-related. The pediatric patients’ age at onset of symptoms was 1.98±1.6 years and the duration of illness was 2.52±2.37 years, lead time to KD start was 2.55±2.41 years. Their function were intellectual disability level on 60% of social quotient and 67% intellectual quotient. Caregivers’s were negative emotion such as clinical level of depression (64%), anxiety (74%), and 40% of the Caregivers’ parenting stress were increased to clinical level particularly in parent-child dysfunctional interaction. Moreover, higher parenting stress were related their negative emotion.

Conclusions:
Adequate, well-designed KD program in pediatric patients with neurological disorders showed benefits in their caregivers’ psychological well-being. The importance of caregivers’ emotional distress and parenting stress for pediatric epilepsy with KD were considered. Moreover, the essential role of medical professionals including pediatrician and pediatric neurologists was highlighted for and comprehensive intervention & total care planning as well as diagnosis of comorbid condition.

Acknowledgements: This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI18C1166).