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 Risk Factors Analysis of Depression and Anxiety in Adult Epilepsy Patients

目的:通过评估成年癫痫患者的抑郁、焦虑状况,分析相关危险因素,探讨有效的干预措施。方法:选取2017年1月-2018年10月笔者所在医院神经内科收治的48例成年癫痫患者,使用汉密尔顿抑郁量表(HAMD)及汉密尔顿焦虑量表(HAMA)评估患者是否存在抑郁、焦虑状态,对患者年龄、性别、职业、学历、病程、发作类型、药物、运动锻炼等进行分析,探究以上因素对癫痫患者抑郁、焦虑的影响,根据危险因素探讨干预措施。结果:48例成年癫痫患者中,有24例出现抑郁或焦虑症状,其中14例(58.33%)抑郁患者,得分率最高的3项分别为抑郁情绪、绝望感、能力减退感;10例(41.67%)焦虑患者,得分率最高的3项分别为焦虑心境、紧张、失眠。经过单因素、Logistic多因素分析,导致成年癫痫患者抑郁、焦虑情绪的独立危险因素为病程长、月收入低、家庭或婚姻负面事件、发作类型全面、发作频率高、运动锻炼少,差异均有统计学意义(P<0.05)。干预后观察组HAMD、HAMA得分均低于干预前,差异均有统计学意义(P<0.05)。结论:成年癫痫患者抑郁、焦虑发生率较高,病程长、月收入低、家庭或婚姻多负性生活事件、癫痫全面发作、发作频率高、无运动锻炼习惯的患者更易发生抑郁、焦虑现象,临床需要根据患者的具体情况采取相应的干预措施预防、控制、改善、消除抑郁、焦虑等负面情绪,提高治疗水平。

Objective:To evaluate the risk factors of depression and anxiety in adult patients with epilepsy and to explore effective intervention measures.Method:A total of 48 patients with epilepsy admitted to the Department of Neurology in our hospital from January 2017 to October 2018 were selected.The Hamilton depression scale(HAMD)and the Hamilton anxiety scale(HAMA)were used to evaluate the depression and anxiety degree.The age,gender,occupation,record of formal schooling,course of disease,type of attack,medicinal and exercise were observed.The effects of the above factors on the depression and anxiety of the patients with epilepsy were investigated,and the intervention measures were discussed according to the risk factors.Result:Among the 48 adult epileptics,24 patients had symptoms of depression or anxiety,14 cases(58.33%)of the patients with depression had the highest scores of depression,the sense of despair and the sense of hypofunction,10 cases(41.67%)of the patients with anxiety had the highest scores of anxiety,tension and insomnia.After univariate,Logistic multifactorial analysis,the independent risk factors leading to depression and anxiety in adult epileptics were long course of disease,low monthly income,negative events in family or marriage,comprehensive type of attack,high frequency of attack,less exercise,the differences were statistically significant(P<0.05).After intervention,the HAMD and HAMA scores in the observation group were lower than those before intervention,the differences were statistically significant(P<0.05).Conclusion:The incidence of depression and anxiety in adult epileptic patients is high,the course of disease is long,the monthly income is low,the family or marriage has more negative sexual events,the seizures are full of seizures,the frequency of seizures is high,and the patients without exercise habit are more prone to depression and anxiety.It is necessary to take corresponding intervention measures to prevent,control,improve,eliminate depression,anxiety and other negative emotions according to the specific situation of the patients.