Laskar Sanghamitra, Chaudhry Neera, Choudhury Cankatika, Garg Divyani
Department of Neurology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
J Neurosci Rural Pract. 2023 Jul-Sep;14(3):482-487. doi: 10.25259/JNRP_34_2023. Epub 2023 Jun 15.
Juvenile myoclonic epilepsy (JME) is the most common idiopathic generalized/genetic epilepsy syndrome. Gender differences are known in clinical presentation, with a well-identified female predilection. We aimed to study gender-based differences in quality of life (QoL) and psychiatric comorbidities among persons with JME.
This was a cross-sectional study conducted at a teaching hospital in Delhi, India. Persons above 11 years of age with JME diagnosed according to the International League Against Epilepsy criteria established in 2001 were enrolled. QoL assessment was made using Quality of Life in Epilepsy Inventory-Adolescents-48 (QOLIE-AD-48) and Patient-Weighted Quality of Life in Epilepsy Inventory 31 (QOLIE-31-P) for adolescent and adult patients, respectively. For the assessment of psychiatric comorbidities, participants were administered the Mini-International Neuropsychiatric Interview (M.I.N.I). Participants who tested positive for psychiatric comorbidities on M.I.N.I subsequently underwent the Diagnostic and Statistical Manual-5 categorization.
We enrolled 50 patients with JME. Eighteen (36%) were male and 32 (64%) were female patients. The median age of males at study enrollment was 23.5 (range 15-38) years. The median age of females was 22 (16-48) years. The median QOLIE-31-P score among males was 68.31 (37.13-91.82) and for females was 66.9 (31.7-99.1). The median overall QoL score for males was 65 (25-87.5), which qualified as "fair" QoL. For females, the median overall QoL score was 62.5 (10-87.5) which also qualified as "fair" QoL. No significant difference was noted between genders in QoL ( = 0.723). Among males, 55.5% had psychiatric comorbidity. Of these, two had mild depression and eight had anxiety. Among female patients, 34.4% had comorbid psychiatric issues; 6 had anxiety and 5 had depression. No significant difference was noted between genders ( = 0.9136).
Persons with JME do not have gender-stratified differences in terms of psychiatric comorbidities and QoL despite differences in exposure to antiseizure medications and other gender-related factors. All persons with JME should be screened for psychiatric comorbidities, specifically anxiety, and depression.
青少年肌阵挛癫痫（JME）是最常见的特发性全身性/遗传性癫痫综合征。已知其临床表现存在性别差异，女性更易患病。我们旨在研究JME患者在生活质量（QoL）和精神共病方面的性别差异。
这是一项在印度德里一家教学医院进行的横断面研究。纳入了11岁以上根据2001年国际抗癫痫联盟标准诊断为JME的患者。分别使用青少年癫痫生活质量量表-48（QOLIE-AD-48）和癫痫患者加权生活质量量表31（QOLIE-31-P）对青少年和成年患者进行生活质量评估。为评估精神共病情况，对参与者进行了迷你国际神经精神访谈（M.I.N.I）。在M.I.N.I测试中精神共病呈阳性的参与者随后进行了《精神疾病诊断与统计手册》第5版分类。
我们纳入了50例JME患者。18例（36%）为男性，32例（64%）为女性患者。男性入组时的中位年龄为23.5岁（范围15 - 38岁）。女性的中位年龄为22岁（16 - 48岁）。男性的QOLIE-31-P中位评分为68.31（37.13 - 91.82），女性为66.9（31.7 - 99.1）。男性的总体生活质量中位评分为65（25 - 87.5），属于“中等”生活质量。女性的总体生活质量中位评分为62.5（10 - 87.5），也属于“中等”生活质量。生活质量在性别之间未发现显著差异（P = 0.723）。男性中，55.5%有精神共病。其中，2例有轻度抑郁，8例有焦虑。女性患者中，34.4%有共病精神问题；6例有焦虑，5例有抑郁。性别之间未发现显著差异（P = 0.9136）。
尽管在抗癫痫药物暴露和其他与性别相关的因素方面存在差异，但JME患者在精神共病和生活质量方面不存在性别分层差异。所有JME患者都应筛查精神共病，特别是焦虑和抑郁。
