Mula Marco, Agrawal Niruj, Mustafa Zainab, Mohanalingham Krithika, Cock Hannah R, Lozsadi Dora A, von Oertzen Tim J
Epilepsy Group, Atkinson Morley Regional Neuroscience Centre, St George's Hospital, London, UK; Institute of Medical and Biomedical Sciences, St George's University of London, UK.
Epilepsy Group, Atkinson Morley Regional Neuroscience Centre, St George's Hospital, London, UK; Institute of Medical and Biomedical Sciences, St George's University of London, UK; Department of Neuropsychiatry, South West London & St George's Mental Health Trust, London, UK.
Epilepsy Behav. 2015 Apr;45:64-7. doi: 10.1016/j.yebeh.2015.03.018. Epub 2015 Apr 7.
The purpose of this study was to identify clinical correlates of self-reported aggressiveness (SRA) in patients with epilepsy treated with levetiracetam (LEV) with special reference to the role of depression.
A consecutive sample of adult outpatients with epilepsy was assessed with the Neurological Disorder Depression Inventory for Epilepsy, the Adverse Event Profile (AEP), and the Emotional Thermometer.
From a total sample of 163 consecutive patients treated with LEV, SRA at any level (from rarely a problem to always) was associated with a 7-fold increased risk of being depressed (95% CI: 3.0-17.5; p<0.001). Self-reported aggressiveness was reported as "always" a problem by 9.8% of the patients. In these patients, apart from depression, SRA was associated with high AEP total scores (55.1 vs. 39.3; p<0.001) and polytherapy (43.8% vs. 19.8%; p=0.034). Anxiety scores were not elevated (4.9 vs. 3.6; p=0.183).
Self-reported aggressiveness during treatment with LEV is not an isolated symptom but is associated with depressed mood. Anxiety-mediated mechanisms do not seem to be involved.
本研究旨在确定接受左乙拉西坦（LEV）治疗的癫痫患者自我报告的攻击性（SRA）的临床相关因素，特别关注抑郁的作用。
对成年癫痫门诊患者连续样本进行癫痫神经障碍抑郁量表、不良事件概况（AEP）和情绪温度计评估。
在163例接受LEV治疗的连续患者总样本中，任何水平的SRA（从很少有问题到总是有问题）与抑郁风险增加7倍相关（95%可信区间：3.0 - 17.5；p<0.001）。9.8%的患者报告自我报告的攻击性“总是”是个问题。在这些患者中，除了抑郁外，SRA与高AEP总分（55.1对39.3；p<0.001）和联合治疗（43.8%对19.8%；p = 0.034）相关。焦虑评分未升高（4.9对3.6；p = 0.183）。
LEV治疗期间自我报告的攻击性不是孤立症状，而是与情绪低落相关。焦虑介导的机制似乎未涉及。
