Mensah Seth A, Beavis Janine M, Thapar Ajay K, Kerr Mike
Academic Department of Neuropsychiatry, Whitchurch Hospital, Cardiff, Wales, UK.
Epilepsy Behav. 2006 Feb;8(1):213-9. doi: 10.1016/j.yebeh.2005.09.014. Epub 2005 Dec 6.
Depression is the most common psychiatric comorbidity in epilepsy, but clinical and other factors associated with this observation and their impact on detection and management of depression in people with epilepsy are poorly understood. This study used a community-based postal questionnaire of primary care-identified people with epilepsy. We were therefore able to explore depression in a nonspecialist care-identified population. Clinical and demographic associative factors were examined. The dependent variable was depression, as defined by a score of 11 or greater on the Hospital Anxiety and Depression Scale (HADS). The prevalence of depression in our sample (n = 499) was found to be 11.2% (95% CI: 8.3-13.7%). Depression was most strongly associated with unemployment. It was also associated with having had a recent seizure and complaints of side effects of antiepileptic medications. Depression was not associated with gender, marital status, or monotherapy or polytherapy antiepileptic medication. The prevalence of depression in epilepsy is greater than in the general population, with no associated female preponderance. Our findings underline important variations in the associative features between depression in the general population and in people with epilepsy, with particular implications for management of this comorbidity.
抑郁症是癫痫最常见的精神科合并症，但与这一现象相关的临床及其他因素，以及它们对癫痫患者抑郁症检测与管理的影响，目前仍知之甚少。本研究采用基于社区的邮政问卷，调查基层医疗机构确诊的癫痫患者。因此，我们能够在非专科护理确诊的人群中探究抑郁症情况。我们对临床和人口统计学相关因素进行了检查。因变量为抑郁症，采用医院焦虑抑郁量表（HADS）评分11分及以上来定义。我们样本（n = 499）中抑郁症的患病率为11.2%（95%可信区间：8.3 - 13.7%）。抑郁症与失业关联最为密切。它还与近期发作及抗癫痫药物副作用的主诉有关。抑郁症与性别、婚姻状况或单药治疗或联合治疗的抗癫痫药物无关。癫痫患者中抑郁症的患病率高于普通人群，且不存在女性占优势的情况。我们的研究结果突显了普通人群与癫痫患者抑郁症相关特征的重要差异，对这种合并症的管理具有特殊意义。
