癫痫患者的精神共病
Psychiatric Comorbidities in People With Epilepsy.
作者信息
Mula Marco, Kanner Andres M, Jetté Nathalie, Sander Josemir W
机构信息
Institute of Medical and Biomedical Education (MM), St George's University of London and the Atkinson Morley Regional Neuroscience Centre, St George's University Hospitals NHS Foundation Trust, London, United Kingdom; Department of Neurology (AMK), Comprehensive Epilepsy Center and Epilepsy Division, University of Miami, Miller School of Medicine, FL; Division of Epilepsy and Division of Health Outcomes and Knowledge Translation Research (NJ), Department of Neurology, Icahn School of Medicine at Mount Sinai, New York; NIHR UCL Hospitals Biomedical Research Centre (JWS), UCL Queen Square Institute of Neurology, London, and Chalfont Centre for Epilepsy, Chalfont St Peter, United Kingdom; and Stichting Epilepsie Instellingen Nederland-SEIN (JWS), Heemstede, the Netherlands.
出版信息
Neurol Clin Pract. 2021 Apr;11(2):e112-e120. doi: 10.1212/CPJ.0000000000000874.
PURPOSE OF REVIEW
To review the latest evidence concerning the epidemiology, clinical implications, and management of psychiatric disorders in epilepsy.
RECENT FINDINGS
People with epilepsy have a 2-5 times increased risk of developing any psychiatric disorder, and 1 in 3 patients with epilepsy have a lifetime psychiatric diagnosis. Psychiatric comorbidities represent a poor prognostic marker as they have been associated with a poor response to treatment (drugs and surgery), increased morbidity, and mortality. Validated screening instruments are available for mood and anxiety disorders in adults as well as attention-deficit hyperactivity disorder in children with epilepsy.
SUMMARY
All patients with epilepsy should be routinely screened for psychiatric disorder at the onset and at least once a year. Patients with epilepsy and their relatives should be informed of the risk of mental health problems and the implications.
综述目的
回顾有关癫痫患者精神障碍的流行病学、临床意义及管理的最新证据。
最新发现
癫痫患者发生任何精神障碍的风险增加2至5倍，三分之一的癫痫患者有终生精神疾病诊断。精神共病是不良预后指标，因为它们与治疗（药物和手术）反应不佳、发病率和死亡率增加有关。有经过验证的筛查工具可用于成人的情绪和焦虑障碍以及癫痫儿童的注意力缺陷多动障碍。
总结
所有癫痫患者在发病时及每年至少应进行一次精神障碍的常规筛查。应告知癫痫患者及其亲属心理健康问题的风险及影响。
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