Kokkonen J, Kokkonen E R, Saukkonen A L, Pennanen P
Department of Paediatrics, University of Oulu, Finland.
J Neurol Neurosurg Psychiatry. 1997 Mar;62(3):265-8. doi: 10.1136/jnnp.62.3.265.
To evaluate social maturation and psychiatric morbidity in young adults treated for epilepsy during their childhood.
Eighty one young adults (43 women, 38 men, mean age 22.3 years) with epilepsy during their childhood were interviewed about their social development and psychiatric symptoms. The results were compared with those from 211 randomly selected controls (106 women, 105 men, mean age 23.2 years).
Compared with the controls the patients had more often not succeeded in passing the normal comprehensive school (20% v 2%) or had left school at the secondary level (53% v 46%) and remained without any vocational education (27% v 11%). There was no significant difference in the employment status of those with work between the patients and the controls. The patients were significantly more often labelled with poor social maturation and dependent lifestyle factors such as living with their parents. However, risk analysis showed that neither the disease itself nor antiepileptic medication were significant predisposing factors for poor social adjustment but low or borderline mental capacity or learning disabilities relating to epilepsy were. Psychiatric morbidity was similar in both groups.
The social handicap found in a certain group of young adults with epilepsy during childhood is largely associated with neurological and cognitive impairments other than epilepsy itself. With the present mode of treatment epilepsy itself does not seem to disturb adolescent social and psychological development.
评估童年期接受癫痫治疗的年轻成年人的社会成熟度和精神疾病发病率。
对81名童年期患癫痫的年轻成年人(43名女性,38名男性,平均年龄22.3岁)进行访谈,了解他们的社会发展情况和精神症状。将结果与211名随机选取的对照组(106名女性,105名男性,平均年龄23.2岁)进行比较。
与对照组相比,患者未能成功完成普通综合学校学业的情况更为常见(20%对2%),或在中学阶段辍学(53%对46%)且未接受任何职业教育的情况也更多(27%对11%)。患者和对照组中有工作者的就业状况无显著差异。患者被显著更多地贴上社会成熟度低和生活方式依赖等标签,如与父母同住。然而,风险分析表明,疾病本身和抗癫痫药物均不是社会适应不良的重要诱发因素,而是与癫痫相关的低或临界智力或学习障碍才是。两组的精神疾病发病率相似。
在某组童年期患癫痫的年轻成年人中发现的社会障碍在很大程度上与癫痫本身以外的神经和认知障碍有关。就目前的治疗方式而言,癫痫本身似乎不会干扰青少年的社会和心理发展。