56例成年癫痫患者抑郁、焦虑的临床评估及危险因素分析

Clinical Evaluation and Analysis of Risk Facters on Depression and Anxiety in 56 Adult Epilepsy Patients

目的:分析总结成年癫痫患者的抑郁、焦虑情况,并评估影响焦虑、抑郁水平的可能危险因素。方法:收集56例成年癫痫患者临床相关资料,应用汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)对患者的焦虑、抑郁程度进行评估,探讨成人癫痫的焦虑、抑郁比例和主要症状,分析性别、年龄、学历、起病年龄、病程、发作频率、发作类型、颞叶癫痫、癫痫家族史、影像学、抗癫痫药物(AEDs)、体育锻炼等因素对患者抑郁、焦虑的影响。结果:56例患者中,抑郁者15例(26.80%),得分率最高的3个单项为抑郁(93.33%),绝望感(86.67%),精神焦虑(86.67%);焦虑者17例(30.40%),得分率最高的3个单项为认知功能(88.24%),紧张(82.35%)及焦虑心境(76.47%)。性别、起病年龄、癫痫家族史、有无运动习惯与抑郁、焦虑评分无明显相关;低学历、癫痫频繁发作、影像学有额颞叶异常的患者易伴发抑郁、焦虑(P<0.05);年龄≥23岁、病程≥9年、部分性发作、颞叶癫痫、AEDs联合治疗则与抑郁相关(P<0.05)。结论:成年癫痫患者伴抑郁、焦虑比例高,症状多样,尤其年龄大、病程长、部分性发作、颞叶癫痫、AEDs联合治疗则易伴发抑郁,低学历、癫痫频繁发作、影像学有额颞叶异常的患者需警惕抑郁、焦虑的可能。

Objective：To evaluate the characteristics and the possible risk factors of depression/anxiety in adult epilepsy patients. Methods： The clinical data of 56 adult epilepsy patients have been retrospectively analyzed. HAMD and HAMA were used to assess the depression/anxiety of each patient. In addition, we have analyzed the possible risk factors such as gender, age, educational background, epilepsy onset age, epilepsy history, seizure frequency, seizure type, temporal lobe epilepsy, epilepsy family history, imaging, AEDs, and sports. Results： In the 56 epilepsy patients, the prevalence of depression and anxiety was 26.8% （15 patients） and 30.4% （17 patients） respectively. The most common items were depression mood （93.33%）, despair feeling （86.67%）, psyche anxiety（30.40%） in HAMD and recognition function（88.24%）, intension（82.35%）, anxiety mood（76.47%） in HAMA. Gender, on-set age, epilepsy history of the family and sports showed no correlation with with HAMA or HAMD. Both HAMD and HAMA were associated with low schooling, frequent seizures and frontal/temporal lobe abnormality on CT/MR （P〈0.05）. Age≥ 23, epilepsy history ≥ 9 years,partial seizures, TLE, multiple AEDs treatment were associated with high score of HAMD （P〈 0.05 ）. Conclusion： The proportion of depression or anxiety in adult epilepsy patients are high with various symptoms. Age ≥ 23, epilepsy history≥ 9 years, partial seizures, temporal lobe epilepsy or multiple AEDs treatment, low education, frequent seizures or frontal/temporal lobe abnormality on CT/MR are the potential risk factor of depression and anxiety.