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患有儿童期起病癫痫的神经典型年轻成年人中的精神障碍与自杀行为。

Psychiatric disorders and suicidal behavior in neurotypical young adults with childhood-onset epilepsy.

作者信息

Baldin Elisa, Hesdorffer Dale C, Caplan Rochelle, Berg Anne T

机构信息

GH Sergievsky Center and Department of Epidemiology, Columbia University, New York, New York, U.S.A.

David Geffen School of Medicine, Semel Institute of Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, California, U.S.A.

出版信息

Epilepsia. 2015 Oct;56(10):1623-8. doi: 10.1111/epi.13123. Epub 2015 Sep 20.

Abstract

OBJECTIVES

We examined the associations of lifetime and current histories of psychiatric disorders and of suicidal thoughts and behaviors with childhood-onset epilepsies in a community-based cohort of young adults.

METHODS

Cases were neurotypical (normal neurologic, cognitive, and imaging examinations and no evidence of a brain insult responsible for the epilepsy) young adults with childhood-onset epilepsy followed since the onset of their epilepsy approximately 15 years earlier and recruited as part of a community-based study. They were compared to two different control groups: siblings and external controls from the National Comorbidity Survey-Replication (NCS-R). The Diagnostic Interview Survey assessed lifetime and current Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) diagnoses of mood disorders and anxiety disorders. Suicidal thoughts and suicide attempt were assessed using the Diagnostic Interview Survey for Children-IV and the Diagnostic Interview Survey (DIS-IV).

RESULTS

Two hundred fifty-seven cases and 134 sibling controls participated in the DIS-IV portion of the young adult assessment. Comparing cases both to their sibling controls and to the controls drawn from the NCS-R, we did not find any evidence to suggest a higher prevalence of lifetime and current mood or anxiety disorders, suicidal thoughts, and suicide attempt in young adults with childhood-onset epilepsies.

SIGNIFICANCE

Our findings from a community-based sample of neurotypical young adults do not suggest a substantial or lasting association between childhood epilepsy and psychiatric disorders and suicidal behavior.

摘要

目的

在一个以社区为基础的青年人群队列中,我们研究了精神疾病的终生史和当前史以及自杀观念和行为与儿童期起病癫痫之间的关联。

方法

研究对象为神经典型(神经系统、认知和影像学检查正常,且无导致癫痫的脑损伤证据)的青年成年人,他们自癫痫发作起约15年前就开始患有儿童期起病的癫痫,并且是作为一项基于社区的研究的一部分招募而来。将他们与两个不同的对照组进行比较:兄弟姐妹以及来自全国共病调查复制版(NCS-R)的外部对照。诊断性访谈调查评估了《精神障碍诊断与统计手册》第四版修订本(DSM-IV-TR)中关于情绪障碍和焦虑障碍的终生和当前诊断。自杀观念和自杀未遂情况使用儿童诊断性访谈调查-IV和诊断性访谈调查(DIS-IV)进行评估。

结果

257例患者和134名兄弟姐妹对照参与了青年成年人评估的DIS-IV部分。将患者与其兄弟姐妹对照以及与从NCS-R中抽取的对照进行比较,我们没有发现任何证据表明患有儿童期起病癫痫的青年成年人中,终生和当前情绪或焦虑障碍、自杀观念以及自杀未遂的患病率更高。

意义

我们从一个以社区为基础的神经典型青年成年人样本中得出的研究结果并不表明儿童期癫痫与精神疾病及自杀行为之间存在实质性或持久性关联。

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