癫合并焦虑

Anxiety in People with Epilepsy

近年来人们日益认识到癫痫（Ep）合并情感性精神障碍的重要性,但多数研究集中干抑郁症。然而,Ep伴发焦虑障碍十分普遍,文献报道焦虑障碍的患病率达111%～46%。有研究表明,Ep和焦虑具有双向联系,且可能有共同的病理生理基础。焦虑严重影响Ep患者的生活质量,放大抗癫药物的不良反应。尽管如此,临床上常忽略对焦虑症状的筛查。Ep患者的焦虑症状可分为仅出现于Ep发作前、中和后（围Ep发作期）的焦虑,类似原发性焦虑障碍的焦虑症,或与Ep本身或其治疗有关的焦虑。对Ep焦虑症状的治疗包括：更有效的控制Ep发作治疗围Ep发作期的焦虑,而大多数形式的焦虑发作以认知行为治疗或药物治疗为主。

Although the importance of the psychiatric comorbidities of epilepsy has been increasingly recognized in recent years,most attention has been focused on depression.However,combined anxiety in epilepsy is affecting 11%～46% of epileptic patients in reports.Recent evidences suggested a bidirectional association of anxiety and epilepsy,with possible common pathophysiology underlying them.Anxiety greatly affects the quality of life in people with epilepsy and enlarges the adverse effects of antiepileptic drugs.Despite this importance,screening for anxiety symptoms is virtually never performed.A variety of anxiety symptoms are observed in epilepsy,including symptoms exclusively around seizures（periictal anxiety）,symptoms resembling primary anxiety disorders,and anxiety directly related to epilepsy or its treatment.Therapeutic approaches include better seizure control for peri-ictal anxiety and cognitive behavioral therapy or pharmacotherapy for most forms of inter-ictal anxiety.