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癫痫患者的精神共病和症状、生活质量与污名化的关系。

The relationship of psychiatric comorbidities and symptoms, quality of life, and stigmatization in patients with epilepsy.

机构信息

Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, Istanbul, Turkey.

Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, Istanbul, Turkey.

出版信息

Epilepsy Behav. 2024 Jul;156:109838. doi: 10.1016/j.yebeh.2024.109838. Epub 2024 May 19.

Abstract

OBJECTIVE

Research around the frequency of psychiatric diseases and psychosocial consequences caused by seizures and stigmatization in patients with epilepsy is important, in terms of multidimensional evaluation of the condition, increasing quality of life, and controlling the frequency of seizures. This prospective study aimed to evaluate relationship between comorbid psychiatric diseases and clinical and sociodemographic data, patients' quality of life and perceived stigma in patients with epilepsy.

METHODS

In this prospective single-center study, we evaluated clinical and demographic data, and characteristics of epilepsy. We used the Symptom Check List 90-Revised (SCL-90-R) as a screening test for psychiatric comorbidities and the Mini International Neuropsychiatric Interview (MINI) test for patients who had an SCL90-R general symptom index (GSI) score of ≥1. The frequency of psychiatric comorbidities, the association between comorbid psychiatric disorders and quality of life, and the level of stigmatization in patients with epilepsy was assessed using the Quality of Life in Epilepsy Inventory (QOLIE-10) and Perceived Stigma Scale.

RESULTS

SCL90-R GSI scores of ≥1 were found in 122 of 300 patients. Psychiatric comorbidities were found in 24.8% (n = 69) of patients with epilepsy in the MINI test, major depression was found in 16.9 %, (n = 47), and generalized anxiety disorder was the most common (5.7 %, n = 16). The number of anti-seizure medications (p = 0.007), high seizure frequency (p = 0.01), seizure in previous 12 months (p = 0.003), history of epilepsy surgery (p = 0.032) and psychiatric disease (p < 0.001), and high perceived stigma (p < 0.001) and QOLIE-10 (p < 0.001) scores were all correlated with psychiatric comorbidities.

CONCLUSIONS

According to the results of our study, an important correlation was determined between psychiatric comorbidities and a history of psychiatric disease, poor quality of life, and high perceived stigma scores in patients with epilepsy. This suggests that screening patients for comorbid psychiatric conditions in epilepsy outpatient clinics is critical, as is establishing a strong collaboration with the psychiatry clinic, to reduce psychosocial issues and the economic burden of stigmatization and improve quality of life.

摘要

目的

研究癫痫患者癫痫发作引起的精神疾病和社会心理后果的频率,从疾病的多维评估、提高生活质量和控制癫痫发作频率的角度来看,是非常重要的。本前瞻性研究旨在评估癫痫患者合并精神疾病与临床和社会人口统计学数据、患者生活质量和感知耻辱之间的关系。

方法

在这项前瞻性单中心研究中,我们评估了临床和人口统计学数据以及癫痫特征。我们使用症状清单 90 修订版(SCL-90-R)作为精神共病的筛查测试,对于 SCL90-R 一般症状指数(GSI)得分≥1 的患者,使用 Mini 国际神经精神访谈(MINI)测试。使用癫痫生活质量量表(QOLIE-10)和感知耻辱量表评估癫痫患者的精神共病频率、合并精神障碍与生活质量的关系以及癫痫患者的耻辱感水平。

结果

在 300 名患者中,有 122 名 SCL90-R GSI 得分≥1。在 MINI 测试中,癫痫患者中发现精神共病 24.8%(n=69),其中重度抑郁症 16.9%(n=47),最常见的是广泛性焦虑症(5.7%,n=16)。抗癫痫药物的数量(p=0.007)、高发作频率(p=0.01)、过去 12 个月内发作(p=0.003)、癫痫手术史(p=0.032)和精神疾病史(p<0.001)以及高感知耻辱(p<0.001)和 QOLIE-10(p<0.001)评分均与精神共病相关。

结论

根据我们的研究结果,确定了癫痫患者的精神共病与精神病史、生活质量差和感知耻辱评分高之间存在重要相关性。这表明在癫痫门诊筛查患者的合并精神疾病状态非常重要,与精神病诊所建立强大的合作关系,以减少社会心理问题和耻辱感带来的经济负担,提高生活质量。

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