Tanabe Takuya, Kashiwagi Mitsuru, Shimakawa Shuichi, Fukui Miho, Kadobayashi Kazuko, Azumakawa Kohji, Tamai Hiroshi, Wakamiya Eiji
Department of Pediatric Neurology, Tanabe-Kadobayashi Children's Clinic, Japan.
Brain Dev. 2013 Jan;35(1):81-6. doi: 10.1016/j.braindev.2012.03.008. Epub 2012 Apr 10.
The aim of this study was to elucidate the availability of the strengths and difficulties questionnaire (SDQ) as a screening tool for identifying behavioral problems in Japanese children with epilepsy.
Eighty-three 4-16 year-old epileptic patients, followed at Tanabe-Kadobayashi Children's Clinic, were studied. Children with severe mental or physical disability were excluded. The Japanese version of the SDQ was used, and scores were compared to the Japanese standard.
'Hyperactivity' was the SDQ category with the most striking differences from normal: a significant numbers of children had scores above the clinically normal range and only a small proportion were within the normal range (p<0.0001). The rates of epilepsy patients with scores above normal range were also significantly higher for 'peer problems' and 'conduct problems' (p<0.0001 and p<0.01). The rates of epilepsy patients with scores within the normal range was significantly lower for 'emotional symptoms' than in normal controls (p<0.001). On the other hand, the 'pro-social behavior' score did not differ significantly from the Japanese standard. As for clinical factors, patients with symptomatic localization-related epilepsy and focal electroencephalographic abnormalities had significantly higher scores for some SDQ items. Age at epilepsy onset correlated negatively with scores for 'total difficulties' and 'hyperactivity', suggesting early onset to be a risk factor for poor SDQ scores.
These findings confirm that higher rates of psychiatric comorbidity in Japanese children with epilepsy may be diagnosed using SDQ in Japanese children with epilepsy. These problems should be addressed in the early phase of epilepsy management in order to preserve health-related quality of life for affected patients.
本研究旨在阐明长处与困难问卷(SDQ)作为一种筛查工具,用于识别日本癫痫儿童行为问题的可用性。
对在田边门林儿童诊所随访的83名4至16岁癫痫患者进行了研究。排除患有严重精神或身体残疾的儿童。使用SDQ日文版,并将得分与日本标准进行比较。
“多动”是SDQ类别中与正常情况差异最显著的一项:大量儿童得分高于临床正常范围,只有一小部分在正常范围内(p<0.0001)。“同伴问题”和“品行问题”得分高于正常范围的癫痫患者比例也显著更高(p<0.0001和p<0.01)。“情绪症状”得分在正常范围内的癫痫患者比例显著低于正常对照组(p<0.001)。另一方面,“亲社会行为”得分与日本标准无显著差异。至于临床因素,症状性局灶相关癫痫和局灶性脑电图异常患者的一些SDQ项目得分显著更高。癫痫发病年龄与“总困难”和“多动”得分呈负相关,提示发病早是SDQ得分低的一个危险因素。
这些发现证实,可以使用SDQ对日本癫痫儿童进行诊断,以发现日本癫痫儿童中较高的精神共病率。这些问题应在癫痫管理的早期阶段加以解决,以维护受影响患者与健康相关的生活质量。