Datta Soumitra Shankar, Premkumar Titus Samson, Fielding Shona, Chandy Sujith, Kumar Sudhir, Eagles John, Cherian Alice
Department of Psychiatry, Christian Medical College, Vellore, Tamil Nadu, India.
Epilepsy Behav. 2006 Aug;9(1):145-51. doi: 10.1016/j.yebeh.2006.04.011. Epub 2006 May 24.
The impact of epilepsy on families has been little studied in the developing countries, where it is the most common neurological disorder among children. In Vellore, India, the impact on 132 families who had a child with epilepsy was rated with the Impact of Pediatric Epilepsy on the Family Scale (IPES). An adverse impact was experienced by 42% of families. Multivariate statistical analysis revealed four factors that were significantly associated with high impact: fewer years since diagnosis (OR=0.81, 95% CI=0.71-0.93), fewer months since last seizure (OR=0.58, 95% CI=0.39-0.87), treatment with multiple antiepileptic drugs (OR=4.34, 95% CI=1.22-15.52), and increased behavior problem scores on the Child Behavior Checklist (OR=1.10, 95% CI=1.05-1.14). Factor analysis of the IPES was also conducted as a comparison with earlier findings in a developed country. We suggest that early monotherapy should be employed whenever possible and that early recognition and treatment of associated psychological problems may help to reduce the burden on families.
在发展中国家,癫痫对家庭的影响鲜有研究,而癫痫却是这些国家儿童中最常见的神经疾病。在印度韦洛尔,运用儿童癫痫对家庭影响量表(IPES)对132个有癫痫患儿的家庭所受影响进行了评估。42%的家庭经历了负面影响。多变量统计分析显示,有四个因素与高影响显著相关:诊断后年限较少(比值比[OR]=0.81,95%置信区间[CI]=0.71 - 0.93)、距上次发作的月份较少(OR=0.58,95% CI=0.39 - 0.87)、使用多种抗癫痫药物治疗(OR=4.34,95% CI=1.22 - 15.52)以及儿童行为量表上行为问题得分增加(OR=1.10,95% CI=1.05 - 1.14)。还对IPES进行了因子分析,以便与发达国家早期的研究结果作比较。我们建议,应尽可能采用早期单一疗法,并且对相关心理问题的早期识别和治疗可能有助于减轻家庭负担。