Li Yanmei, Rao Xueyi, Yang Chunsong, Luo Rong, Cao Dezhi, Gan Jing
Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu 610066 China.
Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu 610066 China.
Epilepsy Behav. 2025 Mar;164:110301. doi: 10.1016/j.yebeh.2025.110301. Epub 2025 Feb 8.
This systematic review with meta-analysis (PROSPERO: CRD42022377532) was performed to comprehensively assess the prevalence of anxiety, depression, and posttraumatic stress disorder (PTSD) in caregivers of children with epilepsy.
A search was performed on June 2024, in 4 databases (PubMed, Embase, Web of Science, and PsycInfo) for original research reporting on caregivers of children with epilepsy, with no language restrictions. Two reviewers independently screened and extracted data. The methodological quality was assessed using the Healthcare Research and Quality of America (AHRQ) standardized appraisal tool. Random-effects models were used to calculate the pooled prevalence of anxiety, depression, and PTSD. The subgroup analysis was further conducted to identify possible sources of heterogeneity. All studies were reviewed by PRISMA guidelines.
A total of 2,588 records were screened and 38 studies with 6,593 participants across 18 countries were included for analysis: 25 studies provided prevalence estimates for anxiety, 33 for depression, and 5 for PTSD. Eleven studies were rated as high quality according to the AHRQ scale, 24 as moderate quality, and 3 as low quality. The pooled prevalence of anxiety was 34 % (95 %CI 0.28-0.41) with considerable heterogeneity (I = 96.18 %), 31 % for depression (95 %CI 0.24-0.37) with substantial heterogeneity (I = 97.60 %), and 21 % for PTSD (95 %CI 0.17-0.26) with moderate heterogeneity (I = 55.02 %). Significant heterogeneity was observed, particularly concerning anxiety and depression, which could be attributed to variations in screening methods. However, no statistical differences were found between subgroups based on gender, region, year of publication, type of seizure, economic development level of countries. In the gender subgroup analysis for PTSD, females had a higher prevalence (24 %) than males (6 %). In the sensitive analysis of PTSD, the prevalence was 23 % with low heterogeneity (I = 22.94 %) by excluding one study.
We systematically analyzed the prevalence of anxiety, depression, and PTSD in caregivers of children with epilepsy. Our findings highlight the high mental health burden among caregivers, with prevalence rates notably higher than those in the general population. These results emphasize the urgent need for early identification, interventions, and comprehensive support to improve the well-being and quality of life of these caregivers.
本系统评价及荟萃分析（PROSPERO：CRD42022377532）旨在全面评估癫痫患儿照料者中焦虑、抑郁和创伤后应激障碍（PTSD）的患病率。
于2024年6月在4个数据库（PubMed、Embase、Web of Science和PsycInfo）中进行检索，以查找关于癫痫患儿照料者的原始研究报告，无语言限制。两名审阅者独立筛选和提取数据。使用美国医疗保健研究与质量（AHRQ）标准化评估工具评估方法学质量。采用随机效应模型计算焦虑、抑郁和PTSD的合并患病率。进一步进行亚组分析以确定异质性的可能来源。所有研究均按照PRISMA指南进行审阅。
共筛选出2588条记录，纳入来自18个国家的38项研究共6593名参与者进行分析：25项研究提供了焦虑患病率估计值，33项提供了抑郁患病率估计值，5项提供了PTSD患病率估计值。根据AHRQ量表，11项研究被评为高质量，24项为中等质量，3项为低质量。焦虑的合并患病率为34%（95%CI 0.28 - 0.41），异质性相当大（I = 96.18%）；抑郁的合并患病率为31%（95%CI 0.24 - 0.37），异质性很大（I = 97.60%）；PTSD的合并患病率为21%（95%CI 0.17 - 0.26），异质性中等（I = 55.02%）。观察到显著的异质性，尤其是焦虑和抑郁方面，这可能归因于筛查方法的差异。然而，基于性别、地区、发表年份、癫痫发作类型、国家经济发展水平的亚组之间未发现统计学差异。在PTSD的性别亚组分析中，女性患病率（24%）高于男性（6%）。在PTSD的敏感性分析中，排除一项研究后患病率为23%，异质性较低（I = 22.94%）。
我们系统分析了癫痫患儿照料者中焦虑、抑郁和PTSD的患病率。我们的研究结果突出了照料者中高心理健康负担，患病率显著高于一般人群。这些结果强调迫切需要早期识别、干预和全面支持，以改善这些照料者的幸福感和生活质量。
