害怕出门：大型成人癫痫中心横断面样本中恐惧症焦虑的生活质量较差。
Afraid to go out: Poor quality of life with phobic anxiety in a large cross-sectional adult epilepsy center sample.
机构信息
Department of Neurology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.
Department of Psychiatry, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.
出版信息
Epilepsy Res. 2023 Feb;190:107092. doi: 10.1016/j.eplepsyres.2023.107092. Epub 2023 Jan 16.
PURPOSE
People with epilepsy (PWE) have unmet healthcare needs, especially in the context of mental health. Although the current literature has established increased incidence of anxiety and depression in PWE and their contribution to poor quality of life, little is known regarding the presence and impact of specific phobia and agoraphobia. Our aim was to assess factors associated with high phobic/agoraphobic symptoms in a large, single tertiary epilepsy center sample, and to assess their impact on quality of life.
METHODS
In a diverse sample of 420 adults with epilepsy, cross-sectional association of demographic, epilepsy and cognitive factors with high phobic symptoms were assessed using multiple logistic regression. Symptoms were measured with the SCL-90R validated self-report subscale (T-score ≥ 60 considered high phobic symptom group). Multiple logistic regression modeling was used to assess for independent association of demographic and clinical variables with presence of high phobic symptoms, and multiple linear regression modeling was used to evaluate for independent cross-sectional associations with epilepsy-specific quality of life (QOLIE-89).
RESULTS
Lower education (adjusted OR 3.38), non-White race/ethnicity (adjusted OR 2.34), and generalized anxiety symptoms (adjusted OR 1.91) were independently associated with high phobic/agoraphobic symptoms, all p < 0.005. Phobic/agoraphobic symptoms were independently associated with poor quality of life as were depression symptoms, older age, and non-White race/ethnicity. Generalized anxiety did not demonstrate a significant independent association with quality of life in the multivariable model.
CONCLUSION
In this study sample, phobic/agoraphobic symptoms were independently associated with poor quality of life. Clinicians should consider using more global symptom screening instruments with particular attention to susceptible populations, as these impactful symptoms may be overlooked using generalized-anxiety focused screening paradigms.
目的
癫痫患者（PWE）存在未满足的医疗保健需求，尤其是在心理健康方面。尽管现有文献已经确定 PWE 中焦虑和抑郁的发病率增加，并且它们对生活质量产生了影响，但对于特定恐惧症和广场恐惧症的存在及其影响知之甚少。我们的目的是评估在大型单一三级癫痫中心样本中与高恐惧症/广场恐惧症症状相关的因素，并评估其对生活质量的影响。
方法
在一个由 420 名成年癫痫患者组成的多样化样本中，使用多元逻辑回归评估人口统计学、癫痫和认知因素与高恐惧症症状的横断面关联。使用 SCL-90R 验证的自我报告子量表（T 评分≥60 被认为是高恐惧症症状组）来衡量症状。使用多元逻辑回归模型来评估人口统计学和临床变量与高恐惧症症状存在的独立关联，以及使用多元线性回归模型来评估与癫痫特异性生活质量（QOLIE-89）的独立横断面关联。
结果
较低的教育程度（调整后的 OR 3.38）、非白种人种族/民族（调整后的 OR 2.34）和广泛性焦虑症状（调整后的 OR 1.91）与高恐惧症/广场恐惧症症状独立相关，所有 p 值均<0.005。恐惧症/广场恐惧症症状与生活质量差独立相关，与抑郁症状、年龄较大和非白种人种族/民族相关。广泛性焦虑在多变量模型中与生活质量没有显著的独立关联。
结论
在本研究样本中，恐惧症/广场恐惧症症状与生活质量差独立相关。临床医生应考虑使用更全面的症状筛查工具，特别关注易感人群，因为使用广泛性焦虑为重点的筛查范式可能会忽略这些有影响的症状。
Zotero 插件