癫痫患者共患焦虑和抑郁现状调查及其危险因素分析

Investigation and risk factors analysis of comorbid anxiety and depression in patients with epilepsy

目的调查癫痫患者共患焦虑、抑郁的现状,并分析影响患者共患焦虑、抑郁的危险因素。方法选取2019年2月—2021年2月在杭州市第七人民医院治疗的癫痫患者285例为研究对象。采用中文版广泛性焦虑障碍量表(GAD-7)和癫痫用神经障碍抑郁量表(NDDI-E)调查癫痫患者共患焦虑、抑郁状况。先采用单因素分析研究与癫痫患者共患焦虑、抑郁有关的因素,再采用多因素logistic回归分析研究影响患者共患焦虑、抑郁的独立危险因素。结果285例癫痫患者共患焦虑47例(16.49%);共患抑郁73例(25.61%);共患抑郁和焦虑42例(14.74%)。多因素logistic回归分析结果显示,病程越长、口服药物种类多、发作频率>2次/月及发作类型为局灶伴意识障碍是癫痫患者共患焦虑的独立危险因素(OR_(病程)=1.514;OR_(口服药物种类)=1.719;OR_(发作频率)=6.455;OR_(发作类型)=3.083);口服药物种类多、发作频率>2次/月及发作类型为局灶伴意识障碍是癫痫患者共患抑郁的独立危险因素(OR_(口服药物种类)=1.773;OR_(发作频率)=5.457;OR_(发作类型)=2.399);发作频率>2次/月、发作类型为局灶伴意识障碍发作是癫痫患者共患焦虑和抑郁的独立危险因素(OR_(发作频率)=7.205;OR_(发作类型)=3.958)。结论癫痫共患焦虑、抑郁的患病率较高,临床应根据危险因素采取针对性措施,同时对患者进行心理咨询和疏导,以降低癫痫患者共患焦虑、抑郁的发生率。

Objective To investigate the status of comorbid anxiety and depression in patients with epilepsy and analyse the risk factors of comorbid anxiety and depression.Methods A total of 285 patients with epilepsy treated in the Seventh People's Hospital of Hangzhou City from February 2019 to February 2021 were recruited in the stduy.The Chinese version of generalised anxiety disorder-7(GAD-7)and epilepsy with neurological disorders and depression inventory for epilepsy(NDDI-E)were used in surveying epileptic patients with anxiety and depression status.Single-factor analysis was used in epileptic patients with anxiety,depression and related factors,and then multi-factor logistic regression analysis was performed in examining the independent risk factors of comorbid anxiety and depression.Results Among the 285 epilepsy patients,47 patients(16.49%)suffered from anxiety,73 patients(25.61%)suffered from depression and 42 patients(14.74%)suffered from both.Multivariate Logistic regression analysis showed that long disease duration,types of oral drugs,seizure frequency of>2 times per month and seizure type with focal disturbance of consciousness were independent risk factors for comorbid anxiety in epileptic patients(OR_(duration)=1.514;OR_(types of oral drugs)=1.719;OR_(seizure frequency)=6.455;OR_(type of seizures)=3.083);multiple types of oral drugs,seizure frequency>2 times/month and seizure type with focal disturbance of consciousness were independent risk factors for comorbid depression in epileptic patients(OR_(type of oral drug)=1.773;OR_(seizure frequency)=5.457;OR_(seizure type)=2.399);seizure frequency of>2 times/month,focal with the disturbance of consciousness seizures were independent risk factors for comorbid anxiety and depression in epilepsy patients(OR_(seizure frequency)=7.205;OR_(seizure type)=3.958).Conclusion The prevalence of comorbid anxiety and depression in epileptic patients is high.Clinical measures should be taken according to risk factors,and psychological counselling and counselling should be carried out to reduce the incidence of anxiety and depression in patients with epilepsy.