Roeder Ruth, Roeder Kathryn, Asano Eishi, Chugani Harry T
Department of Pediatrics, Division of Pediatric Neurology, Children's Hospital of Michigan, Wayne State University, Detroit Medical Center, Detroit, Michigan 48201, USA.
Epilepsia. 2009 Aug;50(8):1943-52. doi: 10.1111/j.1528-1167.2009.02046.x. Epub 2009 Feb 26.
To determine whether previously undetected symptoms of depression and psychiatric help-seeking behaviors are associated with demographic or epilepsy-related variables in a predominantly African American sample of pediatric epilepsy patients.
Ninety-six serially recruited parent-child dyads (55% African American, 39% Caucasian) completed the Short Mood and Feelings Questionnaire (SMFQ). Regression analyses determined whether depressive symptoms measured by the SMFQ were associated with demographic (age, gender, and ethnic background) or epilepsy-related variables (age of seizure onset, duration of epilepsy, seizure type, time since last seizure, and number of antiepileptic drugs). Dyads with positive SMFQ screens (score > or = 12) received information about depression and were advised to seek mental health services. Six months later, parents completed follow-up interviews to ascertain mental health service utilization.
Thirty-five participants (36.5%) screened positive for probable depression. Greater number of antiepileptic drugs was the only predictor variable independently associated with greater (worse) depression scores (p = 0.005). At 6-month follow-up, 12 patients (36.4%) had received mental health care, whereas 21 guardians (63.6%) denied depressive symptoms in their child and never sought mental health services (two dyads lost to follow-up). Logistic regression analyses found no associations between demographic, epilepsy-related, or depressive variables and psychiatric help-seeking.
This study indicates the necessity and feasibility of screening for previously undetected symptoms of depression in pediatric epilepsy clinics serving diverse populations, particularly among patients receiving antiepileptic polytherapy. Additional research on the correlates of depressive symptoms and determinants of psychiatric help-seeking is needed to develop evidence-based interventions for youths with epilepsy and symptoms of depression.
在以非裔美国儿童癫痫患者为主的样本中，确定先前未被发现的抑郁症状及寻求精神科帮助行为是否与人口统计学或癫痫相关变量有关。
96对连续招募的亲子对（55%为非裔美国人，39%为白种人）完成了简易情绪与情感问卷（SMFQ）。回归分析确定SMFQ所测量的抑郁症状是否与人口统计学变量（年龄、性别和种族背景）或癫痫相关变量（癫痫发作起始年龄、癫痫病程、发作类型、距上次发作时间以及抗癫痫药物数量）有关。SMFQ筛查呈阳性（得分≥12）的亲子对会收到有关抑郁的信息，并被建议寻求心理健康服务。6个月后，家长完成随访访谈以确定心理健康服务的利用情况。
35名参与者（36.5%）筛查出可能患有抑郁症。抗癫痫药物数量较多是唯一与更高（更严重）抑郁得分独立相关的预测变量（p = 0.005）。在6个月的随访中，12名患者（36.4%）接受了心理健康护理，而21名监护人（63.6%）否认其孩子有抑郁症状且从未寻求过心理健康服务（2对亲子对失访）。逻辑回归分析发现人口统计学、癫痫相关或抑郁变量与寻求精神科帮助之间无关联。
本研究表明，在为不同人群服务的儿科癫痫诊所中筛查先前未被发现的抑郁症状是必要且可行的，尤其是在接受多种抗癫痫药物治疗的患者中。需要对抑郁症状的相关因素及寻求精神科帮助的决定因素进行更多研究，以制定针对有癫痫和抑郁症状青少年的循证干预措施。
