抑郁、焦虑对癫癎患者健康相关生存质量的影响

Depression, anxiety, and health-related quality of life in adult epilepsy

目的调查癫癎患者健康相关生存质量和情绪健康状况，探讨各种因素对患者生存质量的影响。方法使用世界卫生组织（WHO）生存质量量表中文版简表（QOL-BREF）附加癫癎生存质量量表（QOLIE）-31（中文版）、抑郁自评量表（SDS）、焦虑自评量表（SAS）进行生存质量和心境健康状况调查。多元逐步回归分析各种因素对生存质量的影响。结果癫癎患者（n=141）在WHOQOL—BREF的生理、心理领域得分（分别为12．7±1．8、12．4±1．9）比常模下降（15．1±2．3、13．9±1．9，t=11．75、8．625，P〈0．05）；有抑郁情绪者占57．4％，有焦虑情绪者占39．7％。合并抑郁、焦虑情绪的癫癎患者在除外QOLIE-31药物的影响领域的生存质量各个领域得分均减低；多元逐步回归结果显示，影响QOLIE总分的3个因素按影响作用大小依次是焦虑、抑郁和病程。结论合并抑郁、焦虑情绪障碍，病程长是癫癎患者生存质量下降的重要因素。

Objective To assess health-related quality of life and the mood disorder in adults with epilepsy, and to evaluate factors contributing to the quality of life. Methods Quality of life was measured by the Quality of Life in Epilepsy Inventory （QOLIE-31） and the World Health Organization Quality of Life Assessment-Bref （WHOQOL-BREF）. Psychotic conditions were evaluated by Self-rating Depressive Scale （SDS） and Self-rating Anxious Scale （SAS）. The multivariate analysis was used to assess the determinant factors. Results The study included 141 epilepsy patients in the test group and 59 sex, age, and education matched normal controls. WHOQOL-BREF scores in the physical and psychological aspects were significantly lower in epilepsy patients （12. 7 ± 1.8 and 12.4 ± 1.9, respectively） than those in the normal controls（ 15.1 ± 2. 3 and 13.9 ± 1.9, respectively, t value were 11.75 and 8. 625, both P 〈 0. 05 ）. The survey reported that 57.4% of the epilepsy patients suffered with depression, and 39.7% anxiety. The patients with both anxiety and depression scored lower in all aspects in QOLIE survey except medical effect. Multivariate analysis showed that factors that effect the overall quality of life in order were anxiety, depression and disease duration. Conclusion Our results support that complications of anxiety and depression and long disease duration are key factors affecting the quality of life in epilepsy patients.