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Summary  Reported incidents of challenging behavior over a 6‐month period (December 2011–May 2012) were systematically recorded in young people (8–23 years) with epilepsy (n = 125), and a comparison group of young people without epilepsy (n = 64) at a specialist epilepsy center in the United Kingdom. Factors associated with such incidents were analyzed via regression analysis. The presence of epilepsy was not a significant predictor of recorded challenging behavior. Factors associated with increases in recorded challenging behavior on multivariable analysis in the epilepsy sample were the use of medication for behavioral/psychiatric conditions (p < 0.05) and attending the center on a residential basis (p < 0.001). In the total sample, use of medication for behavioral/psychiatric conditions (p < 0.05), younger age (p < 0.01),  IQ  < 50 (p < 0.01), and residential status (p < 0.001) were associated with increases in recorded challenging behavior. The presence of depression was associated with reduced challenging behavior in the total sample (p < 0.05).The association between the use of psychopharmacology and increased challenging behavior in those with epilepsy and nonepilepsy could indicate a difficult to treat behavioral/psychiatric burden, lack of treatment efficacy, and/or an increased side effect profile and needs further examination.

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Factors associated with reported challenging behavior in young people with epilepsy and neurodevelopmental problems: Data from a specialist epilepsy center