Wang Zhenjie, Guo Chao, Chen Gong, Zhang Lei, Wen Xun, Zheng Xiaoying
Institute of Population Research/WHO Collaborating Center on Reproductive Health and Population Science, Peking University, Beijing, China.
Medicine (Baltimore). 2017 May;96(19):e6831. doi: 10.1097/MD.0000000000006831.
Epilepsy is the third-leading cause of psychiatry disability in China, and intellectual disability (ID) is also 1 major type of disabilities in China. This study estimates the prevalence of comorbidities with ID and epilepsy-related psychiatry disability (EPD) and examines mutual associations within ID and EPD.Data were taken from the Second China National Sample Survey on Disability, which was a nationally representative, population-based survey. To derive a nationally representative sample, the survey used multistage, stratified, cluster random sampling with probability proportional to size. The disabled people who had ID and EPD based on the World Health Organization International Classification of Functioning, Disability, and Health and the International Statistical Classification of Diseases. The cox-proportional hazards model was used to examine the associations between ID and EPD considering the happened sequence of ID and EPD.The prevalence of ID with EPD was 0.14 (95% confidence interval: 0.09-0.19) per 1000 people. Age was strongly associated with the risk of EPD, which was diagnosed after ID, especially among young ID population. Except for age, other variables were also associated between ID and EPD considering sequence of ID and EPD.This study is the first national study to explore mutual associations with ID and EPD and highlights the young ID children with high risk of development of epilepsy. To address the challenge of ID with EPD disability in China, the government should adjust its strategies for healthcare systems to prevent disability.
癫痫是中国精神残疾的第三大病因,智力残疾(ID)也是中国主要的残疾类型之一。本研究估算了智力残疾与癫痫相关精神残疾(EPD)的共病患病率,并考察了智力残疾与癫痫相关精神残疾之间的相互关联。数据取自第二次全国残疾人抽样调查,这是一项具有全国代表性的基于人群的调查。为获取具有全国代表性的样本,该调查采用了多阶段、分层、整群随机抽样,抽样概率与规模成比例。依据世界卫生组织《国际功能、残疾和健康分类》以及《国际疾病统计分类》确定患有智力残疾和癫痫相关精神残疾的残疾人。考虑到智力残疾和癫痫相关精神残疾的发生顺序,采用Cox比例风险模型来考察两者之间的关联。每1000人中智力残疾合并癫痫相关精神残疾的患病率为0.14(95%置信区间:0.09 - 0.19)。年龄与癫痫相关精神残疾的风险密切相关,癫痫相关精神残疾在智力残疾之后被诊断出来,尤其在年轻的智力残疾人群中。除年龄外,考虑到智力残疾和癫痫相关精神残疾的顺序,其他变量在两者之间也存在关联。本研究是第一项探索智力残疾与癫痫相关精神残疾相互关联的全国性研究,突出了癫痫发病风险高的年轻智力残疾儿童。为应对中国智力残疾合并癫痫相关精神残疾的挑战,政府应调整医疗保健系统策略以预防残疾。