癫痫儿童的心理理论能力特点及其影响因素

The characteristics and affecting factors concerning with theory of mind in children with epilepsy

目的探讨原发性或可能症状性癫痫儿童的心理理论能力特点及其影响因素。方法选取54例癫痫儿童(年龄为9~14周岁)和年龄、性别、受教育年限等严格匹配的37例健康儿童作为研究对象,采用心理理论的经典范式(二级错误信念任务、失言识别任务)对其进行评估,比较两组间心理理论任务得分差异,并应用逐步线性回归分析探讨人口统计学素和癫痫相关因素对心理理论的影响。结果癫痫组二级错误信念测试问题、失言识别测试故事的测试问题、认知成分、情感成分得分均低于对照组得分,差异有统计学意义(P<0.05);癫痫组二级错误信念控制问题、失言识别测试故事的控制问题、失言识别对照故事的测试问题、控制问题得分与对照组相比差异无统计学意义。逐步线性回归分析显示,病程、发作控制情况是心理理论的重要影响因素,未显示性别、年龄、发作类型、首发年龄、受教育年限、药物等因素对心理理论的影响。结论原发性或可能症状性学龄期癫痫儿童存在心理理论能力的损害,认知成分和情感成分同时受损,其损害严重程度可能受病程、控制情况的影响。

Objective To study the characteristics of theory of mind（ToM） in children with idiopathic or probably symptomatic epilepsy, further to explore the factors affecting ToM. Methods By adopting cross-sectional analysis, 54 children with idiopathic or probably symptomatic epilepsy at the 9 - to 14-year-old level in the hospital were re- cruited and 37 normally developing children were selected with the similar ages, genders and educational years of epileptic participants. The difference of ToM between two groups was evaluated with classic paradigms of ToM as second-false belief task and faux pas task. The correlation between demographic factors, epilepsy-related factors and ToM were explored by using multiple stepwise regression analysis. Results The scores of children with idio- pathic or probably symptomatic epilepsy in second-false belief, faux pas test, cognitive ToM and affective ToM re- spectively were lower than those of the control group respectively （ P 〈 0. 05 ）. Nevertheless, the differences between two groups in the scores of second-false belief control questions, faux pas stories＇ control questions, control sto- ries＇ test questions, control stories＇ control questions were not statistical different. Multiple stepwise regression a- nalysis indicated that the duration of epilepsy, seizure control were showed remarkable correlation with the sores of second-order false belief tests, faux pas tests. By contrast, other risk factors demonstrated no correlations with ToM. Conclusion Idiopathic or probably symptomatic epileptic children are likely to have deficits in theory of mind, both in cognitive theory of mind and in affective theory of mind. The duration of epilepsy, seizure control are remarkably linked to theory of mind for epileptic children.