G.H. Sergievsky Center and Department of Epidemiology, Columbia University, New York, New York 10032, USA.
Epilepsia. 2011 Feb;52(2):308-15. doi: 10.1111/j.1528-1167.2010.02927.x. Epub 2011 Jan 26.
To estimate the prevalence of neuropsychiatric and pain disorders in adults with epilepsy in the United States.
In 2008, an 11-item survey including validated questions to screen for a lifetime history of epilepsy was mailed to 340,000 households from two national panels selected to be generally representative of the noninstitutionalized U.S. population. Information on epilepsy and other disorders was collected from 172,959 respondents aged 18 or older. Propensity scoring was used to match respondents with and without epilepsy on baseline characteristics and risk factors for epilepsy. Prevalence ratios (PRs) of comorbidities in respondents with epilepsy were calculated using log-binomial generalized linear models. Comorbidities were categorized as neuropsychiatric (anxiety, depression, bipolar disorder, attention-deficit/hyperactivity disorder, sleep disorder/apnea, and movement disorder/tremor), pain (migraine headache, chronic pain, fibromyalgia, neuropathic pain), and other (asthma, diabetes, and high blood pressure).
Two percent (3,488) of respondents reported ever having been told they had epilepsy or a seizure disorder. Respondents with self-reported epilepsy were more likely (p < 0.001) than those without epilepsy to report all six neuropsychiatric disorders (PR from 1.27-2.39), all four pain disorders (PR 1.36-1.96), and asthma (PR 1.25).
Neuropsychiatric conditions and pain disorder comorbidities were reported more often in individuals with self-reported epilepsy than in those without epilepsy. Identification of these conditions is an important consideration in the clinical management of epilepsy.
估计美国癫痫患者中神经精神和疼痛障碍的患病率。
2008 年,一项包括用于筛查终身癫痫病史的 11 项调查问题,被邮寄给来自两个全国性小组的 34 万个家庭,这些家庭被选中作为非住院美国人口的总体代表。年龄在 18 岁或以上的 172959 名受访者提供了关于癫痫和其他疾病的信息。使用倾向评分法,根据基线特征和癫痫风险因素,将有和无癫痫的受访者进行匹配。使用对数二项式广义线性模型计算有癫痫的受访者中合并症的患病率比(PR)。将合并症分为神经精神疾病(焦虑、抑郁、双相情感障碍、注意力缺陷/多动障碍、睡眠障碍/呼吸暂停和运动障碍/震颤)、疼痛(偏头痛、慢性疼痛、纤维肌痛、神经病理性疼痛)和其他疾病(哮喘、糖尿病和高血压)。
2%(3488 人)的受访者报告曾被告知患有癫痫或癫痫发作障碍。与无癫痫的受访者相比,报告有自我报告癫痫的受访者更有可能报告所有六种神经精神疾病(PR 为 1.27-2.39)、所有四种疼痛疾病(PR 为 1.36-1.96)和哮喘(PR 为 1.25)。
与无癫痫的个体相比,有自我报告癫痫的个体更常报告神经精神疾病和疼痛障碍合并症。识别这些疾病是癫痫临床管理中的一个重要考虑因素。