Department of Academic Primary Care Pediatrics, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Pediatrics. 2012 Feb;129(2):256-64. doi: 10.1542/peds.2010-1371. Epub 2012 Jan 23.
To determine sociodemographics, patterns of comorbidity, and function of US children with reported epilepsy/seizure disorder.
Bivariate and multivariable cross-sectional analysis of data from the National Survey of Children's Health (2007) on 91 605 children ages birth to 17 years, including 977 children reported by their parents to have been diagnosed with epilepsy/seizure disorder.
Estimated lifetime prevalence of epilepsy/seizure disorder was 10.2/1000 (95% confidence interval [CI]: 8.7-11.8) or 1%, and of current reported epilepsy/seizure disorder was 6.3/1000 (95% CI: 4.9-7.8). Epilepsy/seizure disorder prevalence was higher in lower-income families and in older, male children. Children with current reported epilepsy/seizure disorder were significantly more likely than those never diagnosed to experience depression (8% vs 2%), anxiety (17% vs 3%), attention-deficit/hyperactivity disorder (23% vs 6%), conduct problems (16% vs 3%), developmental delay (51% vs 3%), autism/autism spectrum disorder (16% vs 1%), and headaches (14% vs 5%) (all P < .05). They had greater risk of limitation in ability to do things (relative risk: 9.22; 95% CI: 7.56-11.24), repeating a school grade (relative risk: 2.59; CI: 1.52-4.40), poorer social competence and greater parent aggravation, and were at increased risk of having unmet medical and mental health needs. Children with prior but not current seizures largely had intermediate risk.
In a nationally representative sample, children with seizures were at increased risk for mental health, developmental, and physical comorbidities, increasing needs for care coordination and specialized services. Children with reported prior but not current seizures need further study to establish reasons for their higher than expected levels of reported functional limitations.
确定有报告癫痫/发作障碍的美国儿童的社会人口统计学、合并症模式和功能。
对国家儿童健康调查(2007 年)中 91605 名年龄在出生至 17 岁的儿童的数据进行双变量和多变量横断面分析,其中包括 977 名父母报告被诊断患有癫痫/发作障碍的儿童。
癫痫/发作障碍的终生估计患病率为 10.2/1000(95%置信区间[CI]:8.7-11.8)或 1%,当前报告的癫痫/发作障碍的患病率为 6.3/1000(95%CI:4.9-7.8)。在低收入家庭和年龄较大、男性儿童中,癫痫/发作障碍的患病率较高。与从未被诊断出患有癫痫/发作障碍的儿童相比,目前报告患有癫痫/发作障碍的儿童更有可能经历抑郁(8%对 2%)、焦虑(17%对 3%)、注意力缺陷/多动障碍(23%对 6%)、行为问题(16%对 3%)、发育迟缓(51%对 3%)、自闭症/自闭症谱系障碍(16%对 1%)和头痛(14%对 5%)(均 P<.05)。他们在完成事情的能力上的受限风险更高(相对风险:9.22;95%CI:7.56-11.24)、留级的风险更高(相对风险:2.59;CI:1.52-4.40)、社会能力较差和父母更苦恼,并且更有可能存在未满足的医疗和心理健康需求。仅有既往发作而无当前发作的儿童风险大致处于中等水平。
在一个具有全国代表性的样本中,患有癫痫的儿童发生心理健康、发育和身体合并症的风险增加,需要更多的护理协调和专门服务。有报告既往但无当前发作的儿童需要进一步研究,以确定其报告的功能受限水平高于预期的原因。