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生活质量及其相关因素在儿童、青少年癫痫患者及其照顾者中的研究:来自德国的一项横断面多中心研究。

Quality of life and correlating factors in children, adolescents with epilepsy, and their caregivers: A cross-sectional multicenter study from Germany.

机构信息

Epilepsy Center Hessen and Department of Neurology, Philipps-University Marburg, Marburg (Lahn), Germany; Department of Pediatrics, Philipps-University Marburg, Marburg (Lahn), Germany.

Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe University Frankfurt, Frankfurt am Main, Germany; LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Frankfurt am Main, Germany.

出版信息

Seizure. 2019 Jul;69:92-98. doi: 10.1016/j.seizure.2019.03.016. Epub 2019 Mar 29.

Abstract

PURPOSE

To identify factors correlating with poorer quality of life (QoL) in children and adolescents with epilepsy and regarding QoL and depression of their caregivers in Germany.

METHOD

A cross-sectional multicenter study on QoL and depression was performed in two representative German states (Hessen and Schleswig-Holstein). Variance analysis, linear regression, and bivariate correlation were used to identify correlating factors for poorer QoL and symptoms of depression.

RESULTS

Data from 489 children and adolescents (mean age 10.4 ± 4.2 years, range 0.5-17.8; 54.0% male) and their caregivers were collected. We identified missing seizure freedom (p = 0.046), concomitant diseases (p = 0.007), hospitalization (p = 0.049), recent status epilepticus (p = 0.035), living in a nursing home or with foster parents (p = 0.049), and relevant degree of disability (p = 0.007) to correlate with poorer QoL in children and adolescents with epilepsy. Poorer QoL of caregivers was associated with longer disease duration (p = 0.004), non-idiopathic (mainly structural-metabolic) epilepsy (p = 0.003), ongoing seizures (p = 0.003), concomitant diseases (p = 0.003), relevant disability (p = 0.003), or status epilepticus (p = 0.003) as well as with unemployment of the primary caretaker (p = 0.010). Symptoms of depression of caregivers were associated with non-idiopathic epilepsy (p = 0.003), concomitant diseases (p = 0.003), missing seizure freedom (p = 0.007), status epilepticus (p = 0.004), or a relevant disability (p = 0.004) of their ward. A poorer QoL value of the children and adolescents correlated with a poorer QoL value of the caregivers (p < 0.001).

CONCLUSIONS

Epilepsy shows a considerable impact on QoL and symptoms of depression. Early and effective therapy should focus on reduction of seizure frequency and the probability for developing status epilepticus. Furthermore, comprehensive care should pay attention at comorbidities, consequences of disability and dependency on others.

摘要

目的

在德国,确定与癫痫患儿生活质量(QoL)较差相关的因素,并确定患儿及其照顾者的 QoL 和抑郁情况。

方法

在德国的两个代表性州(黑森州和石勒苏益格-荷尔斯泰因州)进行了一项关于 QoL 和抑郁的横断面多中心研究。使用方差分析、线性回归和双变量相关性来确定与较差 QoL 和抑郁症状相关的因素。

结果

共收集了 489 名儿童和青少年(平均年龄 10.4±4.2 岁,范围 0.5-17.8;54.0%为男性)及其照顾者的数据。我们发现未达到无发作自由(p=0.046)、并存疾病(p=0.007)、住院(p=0.049)、近期癫痫持续状态(p=0.035)、居住在疗养院或寄养家庭(p=0.049)以及相关残疾程度(p=0.007)与癫痫患儿的较差 QoL 相关。照顾者较差的 QoL 与疾病持续时间较长(p=0.004)、非特发性(主要是结构性代谢性)癫痫(p=0.003)、持续发作(p=0.003)、并存疾病(p=0.003)、相关残疾(p=0.003)或癫痫持续状态(p=0.003)以及主要照顾者失业(p=0.010)有关。照顾者的抑郁症状与非特发性癫痫(p=0.003)、并存疾病(p=0.003)、无发作自由(p=0.007)、癫痫持续状态(p=0.004)或相关残疾(p=0.004)有关。患儿较差的 QoL 值与照顾者较差的 QoL 值相关(p<0.001)。

结论

癫痫对 QoL 和抑郁症状有相当大的影响。早期和有效的治疗应侧重于降低发作频率和发展为癫痫持续状态的概率。此外,综合护理应注意共病、残疾后果和对他人的依赖。

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