癫痫患者人格个性因素对情感障碍和认知障碍影响的研究

Research of influence of individual character factor of personality on epilepsy patient＇s cognitive impairment and affective disorder

目的探讨人格个性因素对癫痫患者情感障碍和认知障碍的影响。方法采用韦氏智力测定、汉密顿情感量表、生活事件量表、艾森克个性问卷和A型行为问卷对患者进行调查。结果癫痫患者认知障碍和情感障碍发生率很高，丙戊酸钠、妥泰、卡马西平单药应用组之间认知功能无显著差异，联合用药组认知障碍和情感障碍均较单药应用严重。多元逐步线性回归检验显示患者职业、文化程度、病程、发作次数、用药选择不同以及是否存在脑部继发性疾病等对认知功能和情感障碍影响显著，相关分析显示患者认知障碍与其焦虑抑郁评分呈明显正相关（r焦虑=0．171，P〈0．01，r抑郁=0．080，P〈0．01），并与其人格个性差异相关。神经质个性者、精神不稳定个性者和外向性格者与患者认知障碍和焦虑抑郁障碍程度呈显著正相关性（rE=0．135，P〈0．01；rN=0．126，P〈0．01；rP=0．136，P〈0．01）。A型行为评分与患者认知障碍和焦虑抑郁障碍程度呈正相关（rTH=0．080，P〈0．01；rCH=0．109，P〈0．01）。结论癫痫患者认知障碍和情感障碍发生率很高，多种因素影响患者的认知功能和情感障碍。患者病理性人格、负性情感反应对患者认知功能损害影响严重。

Objective The study investigates the influence of personality-individual character upon epileptic patients＇ cognitive function and affective disorder. Methods Applying Wechsler Adult Intelligence Scale （WAIS） and 17-item Hamilton Depression Rating Scale （HAMDS） and life incidents scale detect and Eysenck individual character questionnaire （EPQ） and type behavior questionnaire, researchers compared and analyzed features of epileptics＇cognitive function and affective disorder, and the personality-individual character and behavior character of the patients. Results In 320 cases, 259 of them （80.9%）were lower than normal intelligence level （ IQ ≤ 90 分） , 168 cases belong to （ 52.8 % ） mental retardation （ IQ ≤ 70 分 ）, 246 cases （ 76.87 % ） ill with depression, 283 cases（88.43% ） with anxiety. The cognitive impairment and affective disorders of epilepsy patients were serious, According to the different age and course, the cognitive impairment and affective disorder of the patients have the significant differences. With the growth of the patient＇s ages and the extension of the courses, the epilepsy patients with neurotic personality and the state of emotional instability will be more serious. Relevant anal- ysis showed that the cognitive function level and affcctive disorder obviously negativity correlation, that was remarkable correlation with the patient＇s mood, stamina, cognitive function. The correlation analysis showed that the nervousness individual character and unstable individual character patients had obvious dependence with the affective disorder. In addition, to be present negativity life events before the diseases, the incidence of its affectivc disorder had significance statistics differences. Conclusion Cognitive impairment and affective disorder of epilepsy patients are the high incidence. The pathological personality and the negative emotional response in patient＇ s may be to have an important impact on the cognitive function.