Wei Wenjing, Yang Rongrong, Zhang Jie, Chen Haili, Ye Jinghua, Su Qiru, Liao Jianxiang, Xiao Zhitian
China Medical University, Shenzhen Children's Hospital, Shenzhen, China.
Department of Neurology, Shenzhen Children's Hospital, China Medical University, Shenzhen, China.
Front Neurol. 2022 Feb 21;13:831899. doi: 10.3389/fneur.2022.831899. eCollection 2022.
This study was designed to assess the effects of epilepsy severity, family resilience, and social support on depression in primary caregivers of children with epilepsy (CWE), and to test the mediating roles of family resilience and social support in this relationship.
Two hundred fifty-two caregivers of children with epilepsy were recruited from October 2020 to May 2021. The questionnaire contained sociodemographic characteristics, Epilepsy Severity, Chinese-Family Resilience Assessment Scale (C-FRAS), Social Support Rating Scale (SSRS), Beck Depression Inventory (BDI). Structural equation models were used to evaluate whether family resilience and social support as mediators between epilepsy severity and depression.
In this study, the prevalence of depressive symptoms among primary caregivers of CWE in China was 69.84%. Epilepsy severity was positively associated with depression. Family resilience and social support were negatively correlated with depressive symptoms (both < 0.01). Furthermore, the fitness indices of structural models were satisfactory. The direct effect of epilepsy severity on depression was 0.266 (95% CI 0.064-0.458), this pathway explained 62.88% variance of depression. The indirect effect of family resilience and then social support was 0.069 (95% CI 0.025-0.176), indicating that the serial multiple mediation was significant. The serial mediation pathway explained 16.31% variance of depression.
The high incidence of depression among primary carers of CWE deserves more attention. They should be screened routinely, especially those parents of children with severe epilepsy. Family resilience and social support could be protective factors for caregivers' mental adjustment. Therefore, future psychosocial interventions for enhancing family resilience and social support should be implemented, in order to reduce their depression.
本研究旨在评估癫痫严重程度、家庭恢复力和社会支持对癫痫患儿（CWE）主要照顾者抑郁的影响，并检验家庭恢复力和社会支持在这种关系中的中介作用。
2020年10月至2021年5月招募了252名癫痫患儿的照顾者。问卷包括社会人口学特征、癫痫严重程度、中国家庭恢复力评估量表（C-FRAS）、社会支持评定量表（SSRS）、贝克抑郁量表（BDI）。采用结构方程模型评估家庭恢复力和社会支持是否作为癫痫严重程度和抑郁之间的中介。
本研究中，中国癫痫患儿主要照顾者中抑郁症状的患病率为69.84%。癫痫严重程度与抑郁呈正相关。家庭恢复力和社会支持与抑郁症状呈负相关（均P<0.01）。此外，结构模型的拟合指数令人满意。癫痫严重程度对抑郁的直接效应为0.266（95%CI 0.064 - 0.458），该路径解释了抑郁变异的62.88%。家庭恢复力进而社会支持的间接效应为0.069（95%CI 0.025 - 0.176），表明系列多重中介是显著的。系列中介路径解释了抑郁变异的16.31%。
癫痫患儿主要照顾者中抑郁症的高发病率值得更多关注。应定期对他们进行筛查，尤其是重度癫痫患儿的父母。家庭恢复力和社会支持可能是照顾者心理调适的保护因素。因此，未来应实施增强家庭恢复力和社会支持的心理社会干预措施，以减轻他们的抑郁情绪。
