Symbolic function explored in children with epilepsy and headache.

Aim: When the body gets ill, the attack on the ability to think is one of the possible effects that can be observed. The aim of this study is to explore symbolic functions in children with epilepsy and primary headache.

Methods: Fifty five little patients have been recruited from the Neuropsychiatry infant Clinic of the University of Palermo; 48 males (61%) and 27 females (39%), all suffering from epilepsy (53-71%) and primary headache (22-29%), their ages varying from 7 to 11 (average: 9.4+/-1.2). Subjects that had never suffered from chronic or neurological diseases were also recruited as a control group. The control group was levelled with the group to be tested in age and number (75 subjects), age (range: 7-11; average: 9.1+/-9) sex (males: 48-61%; females: 27-39%). The instruments that have been used were: colored progressive matrices in order to measure the development of the cognitive functions; semi-structured interview on dreams in order to estimate the quality of the mentalization; drawing stories technique in order to estimate the quality of the psychological suffering; fairytales method of Düss in order to observe the defensive strategies used by the subjects.

Results: The cognitive performances were the same in the two groups. The answers to the semi-structured interview on dreams were different as far as coherent theory on dreams and memory of the last dream and its quality are concerned. The Drawing stories technique and the Fairytales method of Düss with the children in the clinical group - especially the epileptic patients - showed a high presence of psychical suffering, unprocessed or impossible to process.

Conclusions: The results allow to estimate a psychological suffering, focusing onbody sickness and to discriminate some specific ways of constriction of the imaginary, linked to either repression or to splitting/dissociation.