Cramer Joyce A, Blum David, Reed Michael, Fanning Kristina
Department of Psychiatry, Yale University School of Medicine, 950 Campbell Avenue (G7E), West Haven, CT 06516-2770, USA.
Epilepsia. 2003 Dec;44(12):1578-84. doi: 10.1111/j.0013-9580.2003.28403.x.
To determine the relation between depressive symptoms and seizure severity among people with epilepsy.
A postal questionnaire was used to survey a nationwide community sample about seizures and depression. The Seizure Severity Questionnaire (SSQ) assessed the severity and bothersomeness of seizure components. The Centers for Epidemiological Studies-Depression scale categorized levels of depression.
Respondents categorized as having current severe (SEV, n = 166), mild-moderate (MOD, n = 74), or no depression (NO, n = 443) differed significantly in SSQ scores (all p < 0.0001). People with SEV or MOD reported significantly worse problems than did those with NO depression for overall seizure recovery (mean, 5.3, 4.9, 4.5, respectively); overall severity (5.0, 4.5, 4.2); and overall seizure bother (5.3, 4.8, 4.4) (all p < 0.005). Cognitive, emotional, and physical aspects of seizure recovery also were rated worse among people with SEV than with NO depression (all p < 0.05). Symptoms of depression were significantly correlated with higher levels of all components of generalized tonic-clonic seizure severity (r = 0.33-0.48; all p < 0.0001), and partial seizures (r = 0.31-0.38; all p < 0.01).
Clinically depressed people with epilepsy reported higher levels of perceived severity and bother from seizures, as well as greater problems with overall seizure recovery than did nondepressed people experiencing similar types of seizures. The pervasive influence of depressive symptoms on reports of seizure activity suggests that people with epilepsy should be screened for depression. These data highlight the importance of detecting and treating depression among people with epilepsy.
确定癫痫患者抑郁症状与癫痫发作严重程度之间的关系。
采用邮寄问卷调查全国社区样本的癫痫发作和抑郁情况。癫痫发作严重程度问卷（SSQ）评估癫痫发作各组成部分的严重程度和困扰程度。流行病学研究中心抑郁量表对抑郁水平进行分类。
被归类为当前患有重度抑郁（SEV，n = 166）、轻度 - 中度抑郁（MOD，n = 74）或无抑郁（NO，n = 443）的受访者在SSQ评分上有显著差异（所有p < 0.0001）。与无抑郁的人相比，重度或轻度 - 中度抑郁的人在总体癫痫发作恢复方面报告的问题明显更严重（平均分分别为5.3、4.9、4.5）；总体严重程度（5.0、4.5、4.2）；以及总体癫痫发作困扰程度（5.3、4.8、4.4）（所有p < 0.005）。与无抑郁的人相比，重度抑郁的人在癫痫发作恢复的认知、情绪和身体方面的评分也更差（所有p < 0.05）。抑郁症状与全身强直 - 阵挛性癫痫发作严重程度的所有组成部分的较高水平显著相关（r = 0.33 - 0.48；所有p < 0.0001），与部分性癫痫发作也显著相关（r = 0.31 - 0.38；所有p < 0.01）。
与经历类似类型癫痫发作的非抑郁患者相比，临床上患有抑郁症的癫痫患者报告的癫痫发作严重程度和困扰程度更高，以及在总体癫痫发作恢复方面存在更大问题。抑郁症状对癫痫发作活动报告的普遍影响表明，应对癫痫患者进行抑郁筛查。这些数据突出了在癫痫患者中检测和治疗抑郁症的重要性。
