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[成年早发性癫痫患者社会医学适应中的性别因素]

[Gender aspects of medico-social adaptation in adults with early onset of epilepsy].

作者信息

Grebenyuk O V, Kazennykh T V, Alifirova V M, Svetlik M V, Bokhan N A

机构信息

Siberian State Medical University, Tomsk, Russia.

Mental Health Research Institute, Tomsk, Russia.

出版信息

Zh Nevrol Psikhiatr Im S S Korsakova. 2017;117(6):53-58. doi: 10.17116/jnevro20171176153-58.

Abstract

AIM

To study the relationship between indicators of clinical picture and social adaptation in idiopathic and symptomatic epilepsies with onset before adulthood depending on patient's gender.

MATERIAL AND METHODS

The cross-sectional study was carried out. The study group included 212 women and 171 men, aged 24-60 years, with confirmed diagnosis of epilepsy with onset before 18 years. Seventy-three patients were diagnosed with symptomatic epilepsy, 310 with idiopathic epilepsy. In 120 patients, the frequency of seizures was rarer than once a year. All patients had secondary education and were on treatment with antiepileptic drugs.

RESULTS AND CONCLUSION

In symptomatic epilepsy with early onset, gender differences in family and educational status were not identified. Regardless of gender, patients with myoclonus had higher education more frequently than patients with absence and tonic-clonic seizures. Patients with the combination of different types of seizures, irrespective from etiology and gender, had secondary education more frequently. Women with rare generalized seizures more frequently had higher education and were married. Unmarried men with rare generalized seizures lived separately from their relatives more frequently. To author's opinion, the contradiction in indicators of social adaptation in men with rare generalized seizures, to the great extent, is related to the phenomenon of self-stigmatization than to the influence of disease. The results can be used in rehabilitation of patients with idiopathic epilepsy syndromes.

摘要

目的

研究成年前发病的特发性和症状性癫痫患者的临床表现指标与社会适应之间的关系,并探讨性别差异。

材料与方法

采用横断面研究。研究组包括212名女性和171名男性,年龄在24 - 60岁之间,确诊为18岁前发病的癫痫。73例患者被诊断为症状性癫痫,310例为特发性癫痫。120例患者癫痫发作频率低于每年一次。所有患者均接受过中等教育,且正在接受抗癫痫药物治疗。

结果与结论

在早发性症状性癫痫中,未发现家庭和教育状况存在性别差异。无论性别如何,肌阵挛患者比失神发作和强直 - 阵挛发作患者接受高等教育的频率更高。不同类型发作组合的患者,无论病因和性别,接受中等教育的频率更高。癫痫大发作频率低的女性接受高等教育且已婚的比例更高。癫痫大发作频率低的未婚男性与亲属分开居住的比例更高。作者认为,癫痫大发作频率低的男性在社会适应指标上的矛盾,很大程度上与自我污名化现象有关,而非疾病的影响。这些结果可用于特发性癫痫综合征患者的康复治疗。

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