Kuroda Naoto, Kubota Takafumi
Department of Pediatrics, Wayne State University, Detroit, MI, USA; Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Epilepsy Behav. 2021 Sep 29;124:108340. doi: 10.1016/j.yebeh.2021.108340.
To investigate psychological comorbidities in patients with epilepsy during the coronavirus disease 2019 (COVID-19) pandemic.
A systematic review and meta-analysis approach was used to comprehensively search MEDLINE, CENTRAL, EMBASE, and ClinicalTrials.gov databases for relevant studies. Studies that reported psychological stress in patients with epilepsy during the COVID-19 pandemic were included. Psychological comorbidities were defined as anxiety, depression, and sleep disturbance. Pooled proportions of psychological comorbidities with 95% confidence intervals (CIs) were assessed using a random-effects model. The quality of assessment for each study, heterogeneity between the studies, and publication bias were also evaluated.
A total of 28 studies with 7959 patients/caregivers were included in the meta-analysis. The pooled proportions of anxiety/worry, depression/bad mood, and sleep disturbance were 38.9% (95% CI: 31.3-46.7); I = 97%; p < 0.01, 30.9% (95% CI: 23.3-38.9), I = 97%; p < 0.01, and 36.5% (95% CI: 28.3-45.1), I = 97%, p < 0.01, respectively.
Although the heterogeneity was high, our results showed a relatively high incidence of psychological comorbidities. Therefore, clinicians need to intervene early in the stress of patients with epilepsy to prevent worsening of stress, which can result in seizure worsening.
调查2019冠状病毒病（COVID-19）大流行期间癫痫患者的心理合并症。
采用系统评价和荟萃分析方法，全面检索MEDLINE、CENTRAL、EMBASE和ClinicalTrials.gov数据库中的相关研究。纳入报告COVID-19大流行期间癫痫患者心理压力的研究。心理合并症定义为焦虑、抑郁和睡眠障碍。使用随机效应模型评估心理合并症的合并比例及95%置信区间（CI）。还评估了每项研究的评估质量、研究间的异质性和发表偏倚。
荟萃分析共纳入28项研究，涉及7959名患者/照顾者。焦虑/担忧、抑郁/情绪不佳和睡眠障碍的合并比例分别为38.9%（95%CI：31.3-46.7）；I=97%；p<0.01，30.9%（95%CI：23.3-38.9），I=97%；p<0.01，以及36.5%（95%CI：28.3-45.1），I=97%，p<0.01。
尽管异质性较高，但我们的结果显示心理合并症的发病率相对较高。因此，临床医生需要对癫痫患者的压力进行早期干预，以防止压力恶化导致癫痫发作加重。
