Kuladee Sanchai, Prachason Thanavadee, Srisopit Porntip, Trakulchang Dussanee, Boongird Apisit, Wisajan Pattarabhorn, Jullagate Sudawan
Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Epilepsy Behav. 2019 Jan;90:20-24. doi: 10.1016/j.yebeh.2018.11.004. Epub 2018 Nov 27.
Many studies have shown that the prevalence of psychiatric disorders in patients with epilepsy (PWE) appears higher than that in general population. However, most epidemiological studies regarding psychiatric comorbidities among PWE were conducted in Western countries. This work aimed to determine the prevalence of psychiatric disorders in Thai PWE, including potential variables that could be associated with psychiatric disorders.
A cross-sectional study was conducted at Ramathibodi Hospital. A total of 170 patients (aged 18 years or older) diagnosed as having epilepsy by a neurologist were recruited at the outpatient neurology clinic. Demographic and clinical characteristics were collected. Participants were evaluated for any psychiatric disorders according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, using a structured diagnostic interview. The prevalence of psychiatric disorders was determined. The associations between potential variables and the presence of psychiatric disorders in PWE were analyzed using chi-square or Fisher's exact tests, t-test, and logistic regression.
Among 170 patients, 43 (25.3%) fulfilled diagnostic criteria for one or more psychiatric disorders. The prevalence of depressive disorders was shown to be highest at 17.1%, followed by psychotic disorders (8.2%), bipolar disorder (7.1%), anxiety disorders (5.3%), and obsessive-compulsive disorder (OCD) (2.9%). Electroencephalogram (EEG) abnormalities in the temporal lobe was found to be a significant predictor of having psychiatric disorders in PWE (adjusted odds ratio (OR): 4.01, 95% confidence interval (CI): 1.47-10.92, P-value = 0.007).
The prevalence of psychiatric disorders among Thai PWE was higher than that in general population. Screening for psychiatric disorders in PWE is recommended, especially among those who have EEG abnormalities in the temporal lobe.
许多研究表明，癫痫患者（PWE）的精神障碍患病率似乎高于普通人群。然而，大多数关于PWE精神共病的流行病学研究是在西方国家进行的。这项研究旨在确定泰国PWE中精神障碍的患病率，以及可能与精神障碍相关的潜在变量。
在拉玛蒂博迪医院进行了一项横断面研究。在门诊神经科诊所招募了170名（年龄18岁及以上）经神经科医生诊断为患有癫痫的患者。收集了人口统计学和临床特征。根据《精神障碍诊断与统计手册》第4版，使用结构化诊断访谈对参与者进行任何精神障碍的评估。确定精神障碍的患病率。使用卡方检验或费舍尔精确检验、t检验和逻辑回归分析PWE中潜在变量与精神障碍存在之间的关联。
在170名患者中，43名（25.3%）符合一种或多种精神障碍的诊断标准。抑郁症的患病率最高，为17.1%，其次是精神障碍（8.2%）、双相情感障碍（7.1%）、焦虑症（5.3%）和强迫症（OCD）（2.9%）。发现颞叶脑电图（EEG）异常是PWE患精神障碍的一个重要预测因素（调整后的优势比（OR）：4.01，95%置信区间（CI）：1.47 - 10.92，P值 = 0.007）。
泰国PWE中精神障碍的患病率高于普通人群。建议对PWE进行精神障碍筛查，特别是对那些颞叶有EEG异常的患者。
