Todorova Koraliya S, Kaprelyan Ara G
Clinic of Psychiatry, Clinic of Neurology, St. Marina Hospital, Varna, Bulgaria.
Folia Med (Plovdiv). 2013 Jan-Mar;55(1):70-5. doi: 10.2478/folmed-2013-0008.
Depressive disorders are the most frequent psychiatric comorbidity in epilepsy. Depressive mood affects negatively quality of life (QOL) ratings, sometimes having greater impact than seizure-related variables. Women with epilepsy are a specific subgroup at risk of comorbid depression in consequence of certain biopsychosocial demands. The AIM of this study was to assess the relative contribution of mood, seizure-related and demographic variables on QOL scores in women with epilepsy of childbearing age.
A psychiatric assessment was carried out of 65 women with epilepsy (aged 18-55, mean 37.23 +/- 11.83 yrs). Comorbid depressive disorder was diagnosed according to ICD-10 criteria. Its severity was evaluated on the Hamilton Depression Rating Scale (HAMD-17). A questionnaire for demographic and seizure-related variables was completed. Two self-assessment questionnaires were administered: the Seizure Severity Questionnaire (SSQ) and the Quality of Life in Epilepsy Inventory-31 (QOLIE-31). The data were analysed using SPSS for Windows (version 17.0). Univariate correlation and multiple stepwise regression analyses were performed to explore the association between possible prognostic variables (independent variables) and QOLIE-31 overall and subscale scores (dependent variables).
Analysis showed that demographic factors: employment and education; seizure-related factors: seizure severity, seizure frequency, antiepileptic drug therapy and comorbid depressive disorder were the variables significantly associated with QOLIE-31 overall score (p < 0.01). A three variable model accounted for 64.8% of the variance in QOLIE-31 overall score including seizure severity, comorbid depression and seizure frequency.
Clinical factors are the strongest predictors of QOL of women with epilepsy in our study, seizure severity and comorbid depression being the main contributors. Paying attention to the psychological needs of women with epilepsy will have a positive effect on their QOL.
抑郁症是癫痫最常见的精神共病。抑郁情绪会对生活质量(QOL)评分产生负面影响,有时其影响比与癫痫发作相关的变量更大。由于某些生物心理社会需求,癫痫女性是合并抑郁症风险的特定亚组。本研究的目的是评估情绪、癫痫发作相关和人口统计学变量对育龄期癫痫女性生活质量评分的相对贡献。
对65名癫痫女性(年龄18 - 55岁,平均37.23±11.83岁)进行了精神评估。根据国际疾病分类第10版(ICD - 10)标准诊断合并抑郁症。其严重程度通过汉密尔顿抑郁量表(HAMD - 17)进行评估。完成了一份关于人口统计学和癫痫发作相关变量的问卷。发放了两份自我评估问卷:癫痫发作严重程度问卷(SSQ)和癫痫患者生活质量量表 - 31(QOLIE - 31)。使用SPSS for Windows(版本17.0)对数据进行分析。进行单变量相关性和多步逐步回归分析,以探讨可能的预后变量(自变量)与QOLIE - 31总分及各子量表得分(因变量)之间的关联。
分析表明,人口统计学因素:就业和教育;癫痫发作相关因素:癫痫发作严重程度、发作频率、抗癫痫药物治疗和合并抑郁症是与QOLIE - 31总分显著相关的变量(p < 0.01)。一个三变量模型解释了QOLIE - 31总分64.8%的方差,包括癫痫发作严重程度、合并抑郁症和发作频率。
在我们的研究中,临床因素是癫痫女性生活质量的最强预测因素,癫痫发作严重程度和合并抑郁症是主要因素。关注癫痫女性的心理需求将对她们的生活质量产生积极影响。