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癫痫患者家属的污名化和抑郁症状的相关因素。

Factors associated with stigma and depressive symptoms in family members of patients with epilepsy.

机构信息

Department of Neurology and Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

Department of Neurology, Chung-Ang University College of Medicine, Seoul, Republic of Korea.

出版信息

Epilepsy Behav. 2020 Sep;110:107129. doi: 10.1016/j.yebeh.2020.107129. Epub 2020 May 27.

DOI:10.1016/j.yebeh.2020.107129
PMID:32473520
Abstract

PURPOSE

Literature regarding family stigma related to epilepsy is scarce. This study investigated the prevalence of family stigma and depressive symptoms and the associated factors among the family members of patients with epilepsy.

METHODS

In a cross-sectional study, Stigma Scale-Revised score ≥ 4 and Patient Health Questionnaire-9 score ≥ 10 were considered indicative of moderate-to-severe stigma and depressive symptoms, respectively. Stepwise logistic regression analyses were performed.

RESULTS

Of the 482 family members, a mean age was 47.1 ± 9.4 years, and 73.4% were female. Of the patients, a mean age was 25.5 ± 16.7 years, and 45.0% were female. Idiopathic generalized epilepsy and focal epilepsy were noted in 22.4% and 65.6% of patients, respectively. Family stigma and depressive symptoms were noted in 10.0% and 11.2% of family members, respectively. Family stigma was significantly associated with high seizure frequency and being a sibling or offspring of a patient independent of their depressive symptoms. By contrast, depressive symptoms in family members were significantly associated with polytherapy, being parents of a patient, and neurological comorbidities independent of family stigma. In a subset of patients and their family, patients had higher proportion of stigma and depressive symptoms than their family. Depressive symptoms and stigma among patients were significantly correlated with those among parents, but not spouse.

CONCLUSION

Family stigma is common in families with epilepsy and is closely related to depressive symptoms. Frequent seizures, polytherapy, neurological comorbidities, and the relationship to a patient may be factors that are independently associated with family stigma and depressive symptoms in family members.

摘要

目的

关于癫痫相关家庭耻辱感的文献很少。本研究调查了癫痫患者家庭成员中家庭耻辱感和抑郁症状的患病率以及相关因素。

方法

在一项横断面研究中,将耻辱量表修订版评分≥4 和患者健康问卷-9 评分≥10 分别视为中重度耻辱感和抑郁症状的指标。进行逐步逻辑回归分析。

结果

在 482 名家庭成员中,平均年龄为 47.1±9.4 岁,73.4%为女性。患者的平均年龄为 25.5±16.7 岁,45.0%为女性。分别有 22.4%和 65.6%的患者患有特发性全面性癫痫和局灶性癫痫。分别有 10.0%和 11.2%的家庭成员存在家庭耻辱感和抑郁症状。家庭耻辱感与高发作频率以及作为患者的兄弟姐妹或子女独立相关,与抑郁症状无关。相比之下,家庭成员的抑郁症状与多药治疗、作为患者的父母以及与神经科合并症独立相关,与家庭耻辱感无关。在患者及其家庭的一个亚组中,患者的耻辱感和抑郁症状比例高于其家庭成员。患者的抑郁症状和耻辱感与父母的抑郁症状显著相关,但与配偶的无关。

结论

癫痫患者家庭中普遍存在家庭耻辱感,且与抑郁症状密切相关。频繁发作、多药治疗、神经科合并症以及与患者的关系可能是与家庭成员的家庭耻辱感和抑郁症状独立相关的因素。

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