Risk Factors for Psychiatric Disorders in Pediatric Patients with Tuberous Sclerosis Complex

To identify and evaluate risk factors for psychiatric disorders in pediatric patients with tuberous sclerosis complex (TSC).We recruited 121 children with TSC from the Hangzhou Children's Hospital between April 2021 and December 2023. Four clinical psychiatric scales were used to screen and diagnose the psychiatric comorbidities of TSC: the autism behavior checklist, the SNAP-IV scale, and the self-rating anxiety and depression scales. Risk factors related to each psychiatric disorder were analyzed using univariate and multivariate regression analyses.Comorbid psychiatric disorders were found in 70 (57.85%) children: 51 (42.15%) cases had autism spectrum disorder (ASD), 49 (40.50%) cases had attention-deficit hyperactivity disorder (ADHD), 17 (14.05%) cases had anxiety, and 14 (11.57%) cases had depression. Uni- and multivariate logistic regression analysis revealed that seizure frequency (>1/month; OR = 6.206, <i>P</i> = 0.021), use of anti-seizure medications (≥ 2 types; OR = 118.869, <i>P</i> = 0.003), infantile spasms (OR = 25.748, <i>P</i> = 0.000), ADHD (OR = 11.170, <i>P</i> = 0.001), and intellectual disability (OR = 32.131, <i>P</i> = 0.001) were risk factors for TSC children with ASD; ASD was the only risk factor for occurrence of ADHD (OR = 7.302, <i>P</i> = 0.022). Seizure duration (≥ 2 years; OR = 56.200, <i>P</i> = 0.036) and seizure frequency (>1/month; OR = 25.855, <i>P</i> = 0.027) were closely related to occurrence of anxiety and/or depression disorders in pediatric patients with TSC.The study results showed that psychiatric comorbidities of children with TSC had a high incidence and risk factors. The study provides new insights into the diagnosis and treatment of comorbid psychiatric disorders in pediatric patients with TSC.