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希腊西北部癫痫患者的心理困扰症状和疾病认知。

Psychological distress symptoms and illness perception in patients with epilepsy in Northwest Greece.

机构信息

Department of Neurology, University of Ioannina, University Hospital of Ioannina, Ioannina 45110, Greece.

Department of Neurology, University of Ioannina, University Hospital of Ioannina, Ioannina 45110, Greece.

出版信息

Epilepsy Behav. 2020 Jan;102:106647. doi: 10.1016/j.yebeh.2019.106647. Epub 2019 Nov 27.

Abstract

OBJECTIVE

The purpose of the present study was to compare psychological distress between patients with epilepsy and healthy controls and to evaluate potentially related factors to psychological distress in patients with epilepsy. Furthermore, we assessed how psychological distress and other potential factors mediate illness perception in patients with epilepsy in an urban area of Northwest Greece.

MATERIALS AND METHODS

A case-control study was conducted in adult patients with epilepsy followed up at the University Hospital of Ioannina and in healthy controls. The Symptom Checklist-90 Revised (SCL-90R) for symptoms of psychological distress and the overall psychological distress Global Severity Index (GSI) evaluation, the brief illness perception questionnaire (B-IPQ), and the Adverse Event Profile (AEP) questionnaire for the antiepileptic drugs (AEDs) were used.

RESULTS

Seventy patients with epilepsy and 70 controls were recruited in the study. Somatic, depression, and anxiety symptoms and the GSI were higher in patients than in controls. In patients with epilepsy, the AEP score was significantly associated with psychological distress. Illness perception was associated with the number and the total number of administered AEDs; the AEP score; somatic, obsessive, depressive, and anxiety symptoms; and the GSI. After regression analysis, epilepsy characteristics, AEDs, and psychological distress accounted for 11.7%, 28.7%, and 5.5% of variance in BIP-Q score, respectively.

CONCLUSION

Screening for psychological distress in patients with epilepsy is of high importance in clinical practice as somatic, depression, and anxiety symptoms and overall psychological distress are more severe in patients with epilepsy than in healthy controls. The symptoms of psychological distress are strongly associated with the adverse effects of AEDs. The epilepsy characteristics, the AEDs, and the psychological distress could determine a large part of illness perception in epilepsy, with the adverse effects of AEDs being the strongest predictor.

摘要

目的

本研究旨在比较癫痫患者与健康对照者的心理困扰,并评估癫痫患者心理困扰的相关因素。此外,我们评估了在希腊西北部一个城市地区,心理困扰和其他潜在因素如何在癫痫患者的疾病认知中起中介作用。

材料和方法

在伊奥尼亚纳大学医院对接受随访的成年癫痫患者和健康对照者进行了病例对照研究。使用症状清单 90 修订版(SCL-90R)评估心理困扰症状和总体心理困扰总体严重程度指数(GSI)、简短疾病感知问卷(B-IPQ)和抗癫痫药物(AED)的不良事件概况(AEP)问卷。

结果

本研究纳入了 70 例癫痫患者和 70 例对照者。与对照组相比,癫痫患者的躯体化、抑郁和焦虑症状以及 GSI 更高。在癫痫患者中,AEP 评分与心理困扰显著相关。疾病认知与所服用 AED 的数量和总数、AEP 评分、躯体化、强迫、抑郁和焦虑症状以及 GSI 有关。经过回归分析,癫痫特征、AED 和心理困扰分别解释了 BIP-Q 评分的 11.7%、28.7%和 5.5%的变异性。

结论

在临床实践中,对癫痫患者进行心理困扰筛查非常重要,因为与健康对照组相比,癫痫患者的躯体化、抑郁和焦虑症状以及总体心理困扰更为严重。心理困扰症状与 AED 的不良反应密切相关。癫痫特征、AED 和心理困扰可能在很大程度上决定了癫痫患者的疾病认知,其中 AED 的不良反应是最强的预测因素。

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