Department of Paediatric Liaison, South London and Maudsley NHS Trust, King's College Hospital, London SE5 9RS, United Kingdom of Great Britain and Northern Ireland.
Unit for Social and Community Psychiatry, Centre for Primary Care and Public Health, Queen Mary University of London, E13 8SP, United Kingdom of Great Britain and Northern Ireland.
Epilepsy Behav. 2019 May;94:144-150. doi: 10.1016/j.yebeh.2019.02.014. Epub 2019 Mar 23.
The objective of the study was to assess the influence of gender on psychiatric disorders in children with epilepsy (CWE).
A systematic review of the literature on risk factors for psychiatric disorder in CWE published between 2004 and June 2018 was undertaken. Studies including data on gender that permitted the calculation of a risk ratio (RR) were included in the meta-analysis. A meta-regression was conducted to examine the contribution of setting of the survey and the inclusion of learning disabilities.
Thirty-nine papers were included in the review. The male/female RR in CWE for Attention Deficit Hyperactivity Disorder (ADHD) was 1.49 (Confidence Interval (CI): 1.24-1.79), autistic spectrum disorder (ASD) 1.67 (CI: 1.47 to 1.90), anxiety 1.00 (CI: 0.90-1.12), and depression 0.93 (CI 0.41-2.09). More boys than girls had ADHD and ASD, but in relative terms, the RR male/female was lower in CWE than the RR in the general population reported in other studies. Meta-regression indicated that the inclusion of children with intellectual disability (mental retardation) or the setting (community vs hospital) did not have a significant impact.
Compared with girls in the general population, girls with epilepsy seem to be at a higher risk of being diagnosed with ADHD/ASD as the gender ratio is more equal. This could be related to differences in the assessment of CWE and/or a shared pathogenesis between psychiatric conditions and epilepsy.
本研究旨在评估性别对癫痫儿童（CWE）精神障碍的影响。
对 2004 年至 2018 年 6 月期间发表的关于 CWE 精神障碍风险因素的文献进行系统回顾。纳入的研究需包含性别数据，并允许计算风险比（RR）。进行了元回归分析，以检验调查地点和学习障碍纳入情况的影响。
共纳入 39 篇文献。CWE 注意力缺陷多动障碍（ADHD）的男女 RR 为 1.49（置信区间[CI]：1.24-1.79），自闭症谱系障碍（ASD）为 1.67（CI：1.47-1.90），焦虑症为 1.00（CI：0.90-1.12），抑郁症为 0.93（CI 0.41-2.09）。患有 ADHD 和 ASD 的男孩多于女孩，但相对而言，CWE 中的 RR 男性/女性低于其他研究中报告的一般人群中的 RR。元回归表明，纳入智障儿童或调查地点（社区与医院）并没有显著影响。
与一般人群中的女孩相比，癫痫女孩似乎更有可能被诊断为 ADHD/ASD，因为其性别比例更为均衡。这可能与 CWE 的评估差异或精神障碍和癫痫之间的共同发病机制有关。
