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癫痫患者的感知耻辱感及其潜在影响因素

Felt Stigma and Its Underlying Contributors in Epilepsy Patients.

作者信息

Mao Lingyan, Wang Keying, Zhang Qianqian, Wang Jing, Zhao Yanan, Peng Weifeng, Ding Jing

机构信息

Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai, China.

Teachers College, Columbia University, New York, NY, United States.

出版信息

Front Public Health. 2022 Apr 26;10:879895. doi: 10.3389/fpubh.2022.879895. eCollection 2022.

Abstract

OBJECTIVE

To explore the correlated clinical and psychological factors of stigmatization and investigate the relationship between stigma and white matter abnormalities in epilepsy patients.

METHODS

Stigmatization was obtained by a three-item stigma scale in 256 epilepsy patients with genetic or unknown etiology. Personality and quality of life (QOL) were assessed by Eysenck Personality Questionnaire (EPQ) and QOL-31 questionnaire respectively. One hundred and fourteen of them were performed Hamilton Depression Scale-17 (HAMD) and scanned with diffusion tensor imaging in 3T MRI. Fractional anisotropy (FA) values of frontotemporal contact fibers were calculated.

RESULTS

There were about 39.8% patients felt stigma, with the highest score (Score 3) in 8.2% (21/256). Stigma scores were significantly negatively correlated with education ( < 0.01), age of onset ( < 0.05), extraversion score of EPQ ( < 0.01), total and all the subscale QOL scores ( < 0.001), and positively correlated with duration ( < 0.01), HAMD score ( < 0.001), neuroticism score of EPQ ( < 0.001). We found negative correlation between stigma scores and FA values of right superior longitudinal fasciculus and left cingulum ( < 0.05). Logistic regression results showed that FA value of left cingulum ( = 0.011; OR = 0.000), social function ( = 0.000; OR = 0.935) of QOL, and neuroticism score of EPQ ( = 0.033; OR = 1.123) independently correlated to felt stigma.

CONCLUSION

Felt stigma in epilepsy patients was found to be correlated with neuroticism, depression, and deficient social function of QOL, which might be predisposed by the impairment of the left cingulum. Our results provide preliminary evidence for the underlying neural circuits in stigmatization.

摘要

目的

探讨癫痫患者污名化的相关临床和心理因素,并研究污名与白质异常之间的关系。

方法

采用三项污名量表对256例病因是遗传性或不明的癫痫患者进行污名化调查。分别用艾森克人格问卷(EPQ)和生活质量-31问卷评估人格和生活质量(QOL)。其中114例患者进行了汉密尔顿抑郁量表-17(HAMD)测评,并在3T磁共振成像(MRI)上进行扩散张量成像扫描。计算额颞联络纤维的各向异性分数(FA)值。

结果

约39.8%的患者感到有污名,8.2%(21/256)的患者得分最高(3分)。污名得分与受教育程度(<0.01)、发病年龄(<0.05)、EPQ外向性得分(<0.01)、QOL总分及所有子量表得分(<0.001)呈显著负相关,与病程(<0.01)、HAMD得分(<0.001)、EPQ神经质得分(<0.001)呈正相关。我们发现污名得分与右侧上纵束和左侧扣带的FA值呈负相关(<0.05)。逻辑回归结果显示,左侧扣带的FA值(=0.011;OR=0.000)、QOL的社会功能(=0.000;OR=0.935)和EPQ的神经质得分(=0.033;OR=1.123)与感知到的污名独立相关。

结论

癫痫患者感知到的污名与神经质、抑郁和QOL的社会功能缺陷相关,这可能是由左侧扣带受损所致。我们的结果为污名化潜在的神经回路提供了初步证据。

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