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探讨颞叶癫痫和青少年肌阵挛性癫痫患者的精神共病及其对生活质量的影响。

Exploring psychiatric comorbidities and their effects on quality of life in patients with temporal lobe epilepsy and juvenile myoclonic epilepsy.

机构信息

Department of Neurology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.

Department of Neurology, Bakırköy Research and Training Hospital for Neurologic and Psychiatric Diseases, Istanbul, Turkey.

出版信息

Psychiatry Clin Neurosci. 2017 Apr;71(4):280-288. doi: 10.1111/pcn.12499. Epub 2017 Feb 8.

Abstract

AIM

The relation of epilepsy with psychiatric disorders is of great interest to researchers due to its behavioral, social, and cognitive outcomes. In this study, we explored psychiatric comorbidity and its effects on quality of life (QOL) in patients with mesial temporal lobe epilepsy (MTLE) and juvenile myoclonic epilepsy (JME).

METHODS

Thirty patients with MTLE, 30 patients with JME, and 30 healthy controls underwent the Structured Clinical Interview for DSM-IV (SCID-I) to diagnose psychiatric disorders. None of the subjects had previously undergone psychiatric examination. The Quality of Life in Epilepsy Inventory-89 (QOLIE-89) was used to assess QOL. We compared psychiatric comorbidity among groups and evaluated its effects on QOL.

RESULTS

We detected comorbid psychiatric disorders in 37% of patients with JME and in 57% of patients with MTLE. Comorbid psychiatric disorders were less frequent in healthy controls compared to the patient groups (P = 0.029). Comparing demographic and clinical features of patients with JME and MTLE and their mean QOL scores, there was no statistical difference. Furthermore, we compared QOLIE scores between patients with and without psychiatric comorbidity. JME patients with mood disorders had lower scores on the Attention/Concentration subscale (P = 0.013). MTLE patients with a psychotic disorder had lower scores on the Social Isolation, Energy, and Fatigue subscales (P = 0.045). Patients with somatoform disorders had higher Pain scores (P = 0.04).

CONCLUSION

Our study suggests that comorbid psychiatric disorders negatively affect patients' QOL regardless of seizure syndrome. Comorbid psychiatric conditions should be determined to increase QOL in patients with epilepsy.

摘要

目的

由于癫痫与行为、社会和认知结果有关,因此研究人员对癫痫与精神障碍的关系非常感兴趣。在这项研究中,我们探讨了内侧颞叶癫痫(MTLE)和青少年肌阵挛性癫痫(JME)患者的精神共病及其对生活质量(QOL)的影响。

方法

30 名 MTLE 患者、30 名 JME 患者和 30 名健康对照者接受 DSM-IV 结构临床访谈(SCID-I)以诊断精神障碍。所有受试者均未接受过先前的精神检查。使用癫痫生活质量量表-89 项(QOLIE-89)评估生活质量。我们比较了各组之间的精神共病,并评估了其对 QOL 的影响。

结果

我们发现 JME 患者中有 37%和 MTLE 患者中有 57%存在共患精神障碍。与患者组相比,健康对照组共患精神障碍的频率较低(P=0.029)。比较 JME 和 MTLE 患者的人口统计学和临床特征及其平均 QOL 评分,无统计学差异。此外,我们比较了有和没有精神共病的患者的 QOLIE 评分。伴有心境障碍的 JME 患者在注意力/集中子量表上的得分较低(P=0.013)。伴有精神病性障碍的 MTLE 患者在社会隔离、精力和疲劳子量表上的得分较低(P=0.045)。伴有躯体形式障碍的患者疼痛评分较高(P=0.04)。

结论

我们的研究表明,共患精神障碍无论癫痫综合征如何,都会对患者的 QOL 产生负面影响。应确定共患精神疾病,以提高癫痫患者的 QOL。

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