癫痫患者抑郁焦虑的临床评估及相关因素

Clinical evaluation of depression and anxiety in patients with epilepsy and related factors

目的分析癫痫患者的抑郁、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90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)评价患者是否存在焦虑及抑郁状态,分析性别、年龄、婚姻状况、文化程度、就业、运动习惯、病程、抗癫痫药物(AEDs)种类、发作频率、经历抗癫痫药物不良反应、合并其他系统疾病、家族史、区域等13个可能危险因素对患者抑郁、焦虑的影响。结果90例患者中,焦虑者37例(41.11%),抑郁者35例(38.89%)。癫痫共病焦虑与文化程度、婚姻、就业、运动习惯、发作频率、抗癫痫药物种类、经历抗癫痫药物不良反应及合并其他系统疾病相关(P<0.05)。癫痫共病抑郁与运动习惯、发作频率、抗癫痫药物种类、经历抗癫痫药物不良反应及合并其他系统疾病相关(P<0.05)。多因素Logistic回归分析显示,初中及以下文化程度、发作频率每年>2次、多种抗癫痫药物联用及合并其他系统疾病是癫痫共病焦虑的独立危险因素;运动习惯、发作频率及抗癫痫药物种类是癫痫共病抑郁的独立危险因素。性别、年龄、病程、家族史、区域差异无统计学意义(P>0.05)。结论成年癫痫患者伴抑郁、焦虑比例高,症状多样,尤其发作频率超过每年2次及服用多种抗癫痫药物易伴发焦虑、抑郁状态。

Objective To analyze the depression and anxiety of patients with epilepsy,and to evaluate the possible risk factors affecting the level of anxiety and depression.Methods The clinical data of 90 adult epilepsy patients were collected.The Hamilton anxiety scale(HAMA)and Hamilton depression scale(HAMD)were used to evaluate whether the patients had anxiety and depression.The effects of 13 possible risk factors on depression and anxiety were analyzed,including gender,age,marital status,educational level,employment,exercise habit,course of disease,types of antiepileptic drugs(AEDs),seizure frequency,side effects of antiepileptic drugs,complications of other systemic diseases,family history and region.Results Among the 90 patients,37(41.11%)were anxious and 35(38.89%)were depressed.Epilepsy comorbidity anxiety was associated with education level,marriage,employment,exercise habit,seizure frequency,type of antiepileptic drugs,experience of antiepileptic drug side effects and other systemic diseases(P<0.05).Epilepsy comorbid depression was associated with exercise habits,seizure frequency,type of antiepileptic drugs,experience of antiepileptic drug side effects and other systemic diseases(P<0.05).Multivariate Logistic regression analysis showed that the education level of junior middle school and below,the frequency of seizures more than 2 times per year,the combination of multiple antiepileptic drugs and other systemic diseases were independent risk factors for epilepsy comorbidity anxiety.Exercise habit,seizure frequency and number of antiepileptic drugs were independent risk factors for epileptic comorbid depression.There were no significant differences in gender,age,course of disease,family history and region(P>0.05).Conclusion Adult epilepsy patients with depression and anxiety have a high proportion and various symptoms,especially the frequency of seizures more than 2 times a year and taking a variety of antiepileptic drugs are prone to anxiety and depression.