Chen Qian, Yan Xiu-xian, Shang Ning-xiu, Zhang Gui-zhen, Gao Zhi-jie, Wang Yang, Li Er-zhen, Yang Jian, Xu Ke-ming
Department of Pediatric Neurology, Capital Institute of Pediatrics, Beijing 100020, China.
Zhonghua Er Ke Za Zhi. 2010 May;48(5):346-50.
To find out the rate of comorbidities of depression, anxiety disorder and attention deficit hyperactivity disorder (ADHD) symptoms in children with epilepsy and to analyze the relevant affecting factors and impacts on quality of life.
Totally 142 children with various types of epilepsy underwent neuropsychological assessment with the Depression Self-rating Scale for Children, the Screen for Child Anxiety Related Emotional Disorders and the ADHD Rating Scale-IV, an 18-item parent-rated questionnaire based on the diagnostic criteria for ADHD, the quality of life was measured in 100 cases on antiepileptic medications by the Quality of Life in Epilepsy Inventory (QOLIE-31). The comorbidity rates were calculated using t-test, chi(2) test and multiple logistic analysis, the variables associated with psychiatric comorbidities were determined, and the impact on quality of life was analyzed.
(1) The total rate of emotional and behavioral comorbidities was 57.7% (82/142), the frequency of depressive disorder, anxiety disorder and ADHD was 14.8%, 44.4% and 17.6%, respectively. The suicidal ideation occasionally occurred in 5.6% of the cases and 0.7% of cases often had the ideation, but no suicidal action was found in any case. (2) Risk factors for the emotional and behavioral disorders: multiple logistic analysis indicated that age, gender and epilepsy illness-related variables were not relative to the comorbidities, P > 0.05, there were interactions among the disorders. (3) The impact on the quality of life: The emotional and behavioral conditions were associated with the low quality of life, which was significantly lower in epileptic children with co-morbid disorder compared to non-comorbidities epilepsy group. Especially negative impact on the total score of quality of life and four sub-items such as overall quality, emotional well-being, cognitive and social function, P < 0.001. There were also significant differences between the two groups in the other three sub-items including fear for seizure attack, energy/fatigue and medication effects (P < 0.05).
The frequency of emotional and behavioral disorders including depress disorder, anxiety disorder and ADHD was considerably high in children with epilepsy. Age, gender and epilepsy illness-related variables are not associated with the emotional and behavioral comorbidities, which interfere with each other. Emotional and behavioral disorder is one of the negative factors to the quality of life in epileptic patients. Neuropsychological assessment and treatment are important for improvement of the quality of life in children with epilepsy.
了解癫痫患儿中抑郁症、焦虑症及注意缺陷多动障碍（ADHD）症状的共病率，分析相关影响因素及其对生活质量的影响。
对142例不同类型癫痫患儿采用儿童抑郁自评量表、儿童焦虑相关情绪障碍筛查量表及ADHD评定量表-IV（一种基于ADHD诊断标准的18项家长评定问卷）进行神经心理评估，对100例服用抗癫痫药物的患儿采用癫痫患者生活质量量表（QOLIE-31）测量生活质量。采用t检验、卡方检验及多元逻辑分析计算共病率，确定与精神共病相关的变量，并分析其对生活质量的影响。
（1）情绪和行为共病总发生率为57.7%（82/142），抑郁症、焦虑症及ADHD的发生率分别为14.8%、44.4%和17.6%。5.6%的病例偶尔出现自杀意念，0.7%的病例经常有自杀意念，但未发现任何自杀行为。（2）情绪和行为障碍的危险因素：多元逻辑分析表明，年龄、性别及癫痫疾病相关变量与共病无关，P>0.05，各障碍之间存在交互作用。（3）对生活质量的影响：情绪和行为状况与生活质量低下相关，与无共病的癫痫患儿相比，有共病障碍的癫痫患儿生活质量显著更低。尤其是对生活质量总分及总体质量、情绪幸福感、认知和社会功能等四个子项目有负面影响，P<0.001。两组在其他三个子项目包括对癫痫发作的恐惧、精力/疲劳及药物作用方面也存在显著差异（P<0.05）。
癫痫患儿中包括抑郁症、焦虑症及ADHD在内的情绪和行为障碍发生率相当高。年龄、性别及癫痫疾病相关变量与情绪和行为共病无关，各障碍之间相互干扰。情绪和行为障碍是癫痫患者生活质量的负面因素之一。神经心理评估及治疗对改善癫痫患儿的生活质量很重要。
