Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, United Kingdom.
Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, United Kingdom.
Epilepsy Behav. 2019 Apr;93:16-21. doi: 10.1016/j.yebeh.2019.01.028. Epub 2019 Feb 16.
Seizure disorders affect not only the individual living with seizures, but also those caring for them. Carer-patient relationships may be influenced by, and have an influence on, some aspects of living with seizure disorders - with potentially different interactions seen in epilepsy and psychogenic nonepileptic seizures (PNES).
We studied the influence of patient and carer attachment style and relationship quality on carer wellbeing and psychological distress, and explored whether these associations differ between carers for people with epilepsy and for those with PNES.
Consecutive adult patients with epilepsy (N = 66) and PNES (N = 16) and their primary informal carers completed questionnaires about relationship quality, attachment style, and psychopathological symptom burden. We used correlation analysis to identify associations between relationship quality, attachment style, and carer depression, anxiety, and wellbeing; and to explore differences in these associations between carers for people with epilepsy and for those with PNES.
Overall, 25.3% of carers for people with epilepsy or PNES had scores above the clinical cutoff for depression and 39.6% for anxiety; significantly more carers for people with PNES reported clinically significant depression (47.1% vs. 20.0%), but there was no difference in anxiety rates likely to be of clinical relevance. Correlations differed significantly between carers for people with epilepsy and for those with PNES in terms of patient quality of life and carer anxiety (r = -0.577, r = -0.025); seizure severity and carer depression (r = 0.248, r = -0.333) and mental wellbeing (r = -0.356, r = 0.264); patient depression and carer anxiety (r = 0.387, r = -0.266); and patient anxious attachment and carer anxiety (r = 0.382, r = 0.155).
Clinically evident levels of psychological distress are prevalent among carers for people with epilepsy and PNES. Clinical and relationship variables affect carer quality of life differently depending on whether care is provided for individuals with epilepsy or PNES.
癫痫发作障碍不仅影响患有癫痫发作的个体，还影响照顾他们的人。照顾者-患者关系可能会受到一些与癫痫发作障碍相关的生活方面的影响，并对这些方面产生影响，而在癫痫和非癫痫性发作（PNES）中可能会看到不同的相互作用。
我们研究了患者和照顾者依恋风格和关系质量对照顾者健康和心理困扰的影响，并探讨了这些关联在癫痫和 PNES 患者的照顾者之间是否存在差异。
连续患有癫痫（N=66）和 PNES（N=16）的成年患者及其主要的非正式照顾者完成了关于关系质量、依恋风格和心理病理症状负担的问卷。我们使用相关分析来确定关系质量、依恋风格与照顾者抑郁、焦虑和幸福感之间的关联，并探讨这些关联在癫痫和 PNES 患者的照顾者之间的差异。
总体而言，癫痫或 PNES 患者的 25.3%照顾者的抑郁评分高于临床截止值，39.6%的焦虑评分高于临床截止值；PNES 患者的照顾者中，有显著更多的人报告存在临床显著的抑郁（47.1% vs. 20.0%），但焦虑率没有差异，可能具有临床意义。在患者生活质量和照顾者焦虑方面（r= -0.577，r= -0.025）、癫痫发作严重程度和照顾者抑郁（r= 0.248，r= -0.333）和心理幸福感（r= -0.356，r= 0.264）、患者抑郁和照顾者焦虑（r= 0.387，r= -0.266）以及患者焦虑依恋和照顾者焦虑（r= 0.382，r= 0.155）方面，癫痫和 PNES 患者的照顾者之间的相关性存在显著差异。
在癫痫和 PNES 的照顾者中，明显存在临床显著水平的心理困扰。临床和关系变量会根据照顾者是为癫痫患者还是 PNES 患者提供照顾而对照顾者的生活质量产生不同的影响。
