癫痫共患焦虑和抑郁现状及危险因素分析

Analysis of status quo and related risk factors of epilepsy with anxiety and depression

目的调查癫痫患者共患焦虑抑郁现状,并分析相关危险因素,为癫痫患者焦虑和抑郁的诊治和干预提供思路。方法采用Zung氏焦虑自评量表(SAS)和抑郁自评量表(SDS)对335例确诊癫痫患者进行调查,同时结合患者的临床表现及精神心理疾病诊断标准明确诊断。结果335例癫痫患者焦虑共患率为58.5%,其中轻度、中度和重度共患率分别为36.1%、18.8%和3.6%,不同婚姻状况(χ^(2)=6.375,P=0.041)、职业(χ^(2)=31.963,P=0.000)、经济状况(χ^(2)=22.375,P=0.001)、教育程度(χ^(2)=9.224,P=0.026)、首发年龄(χ^(2)=6.545,P=0.038)和病程(χ^(2)=21.874,P=0.001)的焦虑共患率差异有统计学意义;抑郁共患率为58.8%,其中轻度、中度和重度共患率分别为29.9%、17.0%和11.9%,不同职业(χ^(2)=17.687,P=0.000)、经济状况(χ^(2)=6.728,P=0.035)和病程(χ^(2)=12.521,P=0.002)的抑郁共患率差异有统计学意义。Logistic回归分析显示,教育程度、首发年龄、职业、经济状况和病程是共患心理疾病的独立危险因素。教育程度高、经济状况好、心理疾病共患率低,首发年龄越大、病程越长,心理疾病共患率越高。结论癫痫患者合并焦虑和抑郁的患病率较高,直接影响其生活质量,应及早开展焦虑和抑郁的筛查评估并采取针对性干预措施。

Objectives To investigate the situation of epilepsy patients with anxiety and depression,analyze the relevant risk factors,and provide idea for diagnosis,treatment,and intervention of anxiety and depression in epilepsy patients.Methods The Zung's self-assessment scale for anxiety(SAS)and self-assessment scale for depression(SDS)were used for investigation of 335 epilepsy patients.Meanwhile,the diagnosis was clarified according to the clinical features and the diagnostic standard of mental psychological illness.Results The comorbid rate of epilepsy patients with anxiety was 58.5%in 335 epilepsy patients,and the mild,moderate and severe comorbid rates was 36.1%,18.8%and 3.6%,respectively.There were statistical differences in the comorbid rates of marital status(χ^(2)=6.375,P=0.041),occupations(χ^(2)=31.963,P=0.000),economic status(χ^(2)=22.375,P=0.001),education background(χ^(2)=9.224,P=0.026),age of first onset(χ^(2)=6.545,P=0.038)and courses of diseases(χ^(2)=12.521,P=0.002).The comorbid rate of epilepsy patients with depression was 58.8%,and the mild,moderate and severe comorbid rates was 29.9%,17.0%and 11.9%,respectively.There were statistical differences in the comorbid rates of occupations(χ^(2)=17.687,P=0.000),economic status(χ^(2)=6.728,P=0.035)and courses of diseases(χ^(2)=12.521,P=0.002).The results of Logistic regression analysis showed that the education background age of first onset,occupation,economic status and course of disease were the independent risk factors of epilepsy patients with anxiety and depression.The comorbid rate of psychological illness was low if the education level was high,economic status was good.The older age of first onset and longer course of disease,the higher comorbid rate of psychological illness.Conclusions The prevalence rate of epilepsy patients with anxiety and depression is high,and directly affect quality of life of the patients.The screening and assessment of anxiety and depression should be carried out as earlier as possible in epilepsy patients,so as to take targeted intervention measures.