Matsuura Masato, Oana Yasunori, Kato Masaaki, Kawana Akinori, Kan Rumiko, Kubota Humio, Nakano Takashi, Hara Tsunekatsu, Horikawa Naoshi
Department of Neuropsychiatry, Surugadai Nihon University Hospital, Nihon University School of Medicine, Tokyo, Japan.
Epilepsia. 2003 Jan;44(1):107-14. doi: 10.1046/j.1528-1157.2003.25202.x.
To investigate the prevalence rate and risk factors of psychiatric disorders among new referrals for epilepsy, a multicenter study was conducted by using the International League Against Epilepsy (ILAE) criteria for epilepsy and the ICD-10 criteria for psychiatric disorders.
From April 2000 to March 2001, 398 patients with epilepsy, who were referred to nine neuropsychiatric outpatient clinics specialized for epilepsy in the Tokyo metropolitan area, were evaluated by using a newly developed five-axis classification scheme.
Forty-two percent of the subjects showed a psychiatric disorder. Twenty-four percent of the total showed psychiatric disorders, including neurotic disorders in 8%, psychotic disorders in 7%, and affective disorders in 1%. In addition, 23% of the total showed mental retardation, and 18% showed personality disorders. A logistic regression analysis revealed that the three risk factors for a psychiatric disorder were mental retardation, temporal lobe epilepsy (as opposed to other subtypes), and a high seizure frequency.
The presence of mental retardation was the primary risk factor for developing a psychiatric disorder, especially a schizophrenia-spectrum disorder. The type of epilepsy alone is not a strong predictor of psychiatric illness, and intractable temporal lobe epilepsy with a high seizure frequency is accountable for the link between the epilepsy and the psychiatric illness.
为调查癫痫新转诊患者中精神障碍的患病率及危险因素，采用国际抗癫痫联盟（ILAE）的癫痫诊断标准和国际疾病分类第十版（ICD - 10）的精神障碍诊断标准进行了一项多中心研究。
2000年4月至2001年3月，对转诊至东京都市区9家癫痫专科神经精神科门诊的398例癫痫患者，采用新开发的五轴分类方案进行评估。
42%的受试者存在精神障碍。总计24%的患者存在精神障碍，其中神经症性障碍占8%，精神障碍占7%，情感障碍占1%。此外，总计23%的患者存在智力发育迟缓，18%的患者存在人格障碍。逻辑回归分析显示，精神障碍的三个危险因素是智力发育迟缓、颞叶癫痫（相对于其他亚型）和高癫痫发作频率。
智力发育迟缓的存在是发生精神障碍尤其是精神分裂症谱系障碍的主要危险因素。仅癫痫类型并非精神疾病的有力预测因素，而具有高癫痫发作频率的难治性颞叶癫痫是癫痫与精神疾病之间联系的原因。
