Weatherburn Christopher J, Heath Craig A, Mercer Stewart W, Guthrie Bruce
Quality, Safety and Informatics Research Group, Population Health Sciences Division, Ninewells Hospital and Medical School, University of Dundee, Mackenzie Building, Kirsty Semple Way, Dundee DD2 4BF, UK.
Institute of Neurological Sciences, Southern General Hospital, Glasgow G51 4TF, UK.
Seizure. 2017 Feb;45:125-131. doi: 10.1016/j.seizure.2016.11.013. Epub 2016 Nov 23.
To measure the prevalence of physical and mental health comorbidities in people with epilepsy in a large population cohort, and to examine the prevalence of depression accounting for other physical comorbidity.
Population-based, cross-sectional descriptive epidemiology analysis of primary care electronic records for 1,510,742 people aged 14+ years, examining the prevalence of 39 comorbidities.
12,720 people with epilepsy were identified (prevalence 8.4/1000 population, 95% CI 8.3-8.5). Physical and mental health comorbidity was more common with epilepsy (mean of an additional 1.02 physical conditions difference, 95% CI 0.99-1.06). 69.9% of people with epilepsy had one or more comorbid health conditions and 18.6% had four or more, compared to 46.9% and 9.0% of people without epilepsy. Depression was present in 16.3% of people with epilepsy compared to 9.5% of those without (adjusted OR 1.57, 95% CI 1.49-1.65). The prevalence of comorbid depression in epilepsy increased as the number of physical comorbidities increased (OR 5.82, 95% CI 4.90-6.91 for 4+ physical comorbidities vs none) and with increasing deprivation, similar to the patterns observed in other common physical conditions.
People with epilepsy have higher rates of both physical and mental health comorbidity than people without even after adjustment for age, gender and levels of deprivation. Depression is more common than in the general population but the prevalence is similar to other physical health conditions, and is strongly associated with the total burden of physical conditions. This study highlights the complexity in caring for people with epilepsy.
在一个大型人群队列中测量癫痫患者身心健康共病的患病率，并研究在存在其他身体共病的情况下抑郁症的患病率。
对1510742名14岁及以上人群的初级保健电子记录进行基于人群的横断面描述性流行病学分析，调查39种共病的患病率。
共识别出12720名癫痫患者（患病率为8.4/1000人口，95%置信区间8.3 - 8.5）。癫痫患者的身心健康共病更为常见（平均额外存在1.02种身体疾病差异，95%置信区间0.99 - 1.06）。69.9%的癫痫患者有一种或多种共病健康状况，18.6%的患者有四种或更多，而无癫痫患者的这两个比例分别为46.9%和9.0%。癫痫患者中16.3%存在抑郁症，无癫痫患者中这一比例为9.5%（调整后的比值比为1.57，95%置信区间1.49 - 1.65）。癫痫中共病抑郁症的患病率随着身体共病数量的增加而上升（4种及以上身体共病与无身体共病相比，比值比为5.82，95%置信区间4.90 - 6.91），并且随着贫困程度的增加而上升，这与在其他常见身体疾病中观察到的模式相似。
即使在对年龄、性别和贫困水平进行调整后，癫痫患者的身心健康共病率仍高于无癫痫患者。抑郁症在癫痫患者中比在一般人群中更常见，但患病率与其他身体健康状况相似，并且与身体疾病的总负担密切相关。本研究凸显了照顾癫痫患者的复杂性。
