Department of Neurology, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, United States; Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd., Houston, TX 77030, United States.
Department of Neurology, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, United States.
Epilepsy Behav. 2024 Aug;157:109871. doi: 10.1016/j.yebeh.2024.109871. Epub 2024 Jun 3.
Hispanic/Latino people with epilepsy may be at a differential risk of medical and psychiatric comorbidities given genetic, environmental, sociocultural, and quality of care factors. In people with epilepsy, comorbidities are especially crucial to investigate given the well-known impact on quality of life and risk of adverse outcomes. Yet, Hispanic/Latino Veterans with Epilepsy (HL-VWE) remain an understudied population. The present nationwide population study sought to investigate medical and psychiatric comorbidities in this group.
Data from the Veterans Health Administration (VHA) Corporate Data Warehouse administrative data were used to identify 56,556 VWE (5.7 % HL-VWE) using a one-year cross-sectional analysis of ICD codes. Elixhauser Comorbidity Index scores and psychiatric diagnoses were calculated based on ICD-9/ICD-10-CM diagnoses using a lookback period. Comparisons were made between HL-VWE and non-HL-VWE using chi-squared and student t-tests. Regression analyses were then performed to examine group differences while accounting for age.
HL-VWE had higher probability of being diagnosed with several psychiatric conditions when accounting for age, including depression (OR 1.21, 95 % CI 1.13-1.31) and schizophrenia (OR 1.56, 95 % CI 1.31-1.84). There were no significant differences in medical comorbidities between the HL-VWE and non-HL-VWE groups.
We present results from the largest known study of HL people with epilepsy examining their psychiatric and medical comorbidities and one of the first to specifically study HL-VWE. Compared to non-HL-VWE, the Hispanic/Latino group had comparable medical comorbidity, but higher rates of multiple psychiatric conditions. Results indicate a need for increased screening and interventions in this population to reduce psychiatric disease burden.
由于遗传、环境、社会文化和医疗保健质量等因素，患有癫痫的西班牙裔/拉丁裔人群可能面临着不同的医疗和精神共病风险。在癫痫患者中，共病尤其需要进行研究，因为它们对生活质量和不良后果风险有着显著的影响。然而，西班牙裔/拉丁裔癫痫退伍军人（HL-VWE）仍然是一个研究不足的人群。本项全国性人群研究旨在调查该人群的医疗和精神共病情况。
利用退伍军人健康管理局（VHA）企业数据仓库的行政数据，通过对 ICD 编码的一年横断面分析，确定了 56556 名 VWE（5.7%为 HL-VWE）。根据 ICD-9/ICD-10-CM 诊断，利用回溯期计算了 Elixhauser 共病指数评分和精神科诊断。采用卡方检验和学生 t 检验比较 HL-VWE 和非 HL-VWE 之间的差异。然后进行回归分析，在考虑年龄的情况下，检查组间差异。
在考虑年龄的情况下，HL-VWE 被诊断出患有多种精神疾病的可能性更高，包括抑郁症（OR 1.21，95%CI 1.13-1.31）和精神分裂症（OR 1.56，95%CI 1.31-1.84）。HL-VWE 和非 HL-VWE 之间在医疗共病方面没有显著差异。
我们展示了迄今为止规模最大的针对西班牙裔癫痫患者的研究结果，研究了他们的精神和医疗共病情况，也是首次专门研究 HL-VWE 的研究之一。与非 HL-VWE 相比，西班牙裔/拉丁裔群体的医疗共病情况相当，但多种精神疾病的发病率更高。结果表明，该人群需要增加筛查和干预措施，以减轻精神疾病负担。
