Division of Behavioral Medicine and Clinical Psychology, Center for the Promotion of Adherence and Self-Management, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA.
Division of Behavioral Medicine and Clinical Psychology, Center for the Promotion of Adherence and Self-Management, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA.
Epilepsy Behav. 2019 Jul;96:57-60. doi: 10.1016/j.yebeh.2019.04.017. Epub 2019 May 9.
The current study compared differences in health-related quality of life (HRQOL) between youth with new-onset epilepsy with and without elevated psychological symptoms at time of epilepsy diagnosis within an integrated behavioral health and epilepsy service. Patients received both behavioral health and epilepsy care during clinic visits. A retrospective chart review was conducted between July 2011 and December 2015. Caregivers completed the Behavior Assessment System for Children-2: Parent Rating Scale (BASC-2: PRS) to assess psychological symptoms at the diagnostic visit, along with completing the Pediatric Quality of Life Inventory (PedsQL™ 4.0) at the diagnostic visit and each subsequent epilepsy clinic visit during the first year of treatment. Latent growth curve modeling was used to identify HRQOL changes over the first year of treatment. Health-related quality of life was significantly lower for youth with elevated psychological symptoms at diagnosis and over the first year of treatment compared with those without psychological symptoms. For those with elevated internalizing, inattention, withdrawal, and atypical symptoms at diagnosis, greater HRQOL improvements were detected over the first year of treatment compared with those without elevated psychological symptoms at the diagnostic visit. Within integrated behavioral health and epilepsy routine care, targeted psychological interventions can improve HRQOL over the first year of treatment, particularly for those with premorbid psychological symptoms.
本研究比较了在综合性心理健康和癫痫服务中，癫痫诊断时伴有和不伴有心理症状升高的新发癫痫青少年之间的健康相关生活质量（HRQOL）差异。患者在就诊期间同时接受心理健康和癫痫护理。对 2011 年 7 月至 2015 年 12 月期间的病历进行了回顾性图表审查。在诊断就诊时，照顾者使用儿童行为评估系统-2：家长评定量表（BASC-2：PRS）评估心理症状，并在诊断就诊时以及治疗的第一年中每次后续的癫痫就诊时完成儿童生活质量问卷（PedsQL™ 4.0）。潜在增长曲线模型用于确定治疗第一年的 HRQOL 变化。与无心理症状者相比，诊断时心理症状升高的青少年以及治疗的第一年中，其 HRQOL 明显较低。对于那些在诊断时存在内化、注意力不集中、退缩和非典型症状升高的青少年，与诊断就诊时无心理症状升高的青少年相比，治疗的第一年中 HRQOL 改善更大。在综合性心理健康和癫痫常规护理中，针对性的心理干预可以在治疗的第一年中提高 HRQOL，尤其是对于那些有前期心理症状的患者。
