癫痫患者的精神疾病发病率：一项针对领取残疾福利金成年人的病例对照研究。
Psychiatric morbidity in epilepsy: a case controlled study of adults receiving disability benefits.
作者信息
Stefansson S B, Olafsson E, Hauser W A
机构信息
State Social Security Institute, Reykjavik, Iceland.
出版信息
J Neurol Neurosurg Psychiatry. 1998 Feb;64(2):238-41. doi: 10.1136/jnnp.64.2.238.
OBJECTIVE
To compare the prevalence of non-organic psychiatric disorders among disabled patients of normal intelligence with epilepsy with the prevalence of similar psychiatric disorders among age and sex matched disabled patients with other somatic diseases.
METHODS
A case-control study was carried out in Iceland among people receiving disability benefits using information available at the State Social Security Institute. There were 344 patients with epilepsy in Iceland 16 to 66 years of age (inclusive) receiving disability benefits in 1995. By excluding mentally retarded patients, autistic patients, and patients with organic psychoses, 241 index cases with epilepsy qualified for the study. For each case two age and sex matched controls were selected from all patients receiving disability benefits who had cardiovascular diseases, respiratory diseases, or arthropathies. The same exclusion criteria were applied to the controls as the index cases. In both patient groups psychiatric diagnoses were classified into one of the four following categories: (1) psychotic illness; (2) neurotic illness or personality disorders; (3) alcohol or drug dependence or misuse; and (4) other mental disorders.
RESULTS
Psychiatric diagnosis was present among 35% (85/241) of the cases compared with 30% (143/482) of the controls (p=0.15). There was a difference in the distribution of the two groups into different psychiatric categories (p=0.02). This was mainly due to an excess of men in the index group with psychosis, particularly schizophrenia or paranoid states.
CONCLUSION
The results suggest that there is not a difference in the prevalence of non-organic psychiatric disorders among disabled patients of normal intelligence with epilepsy compared with patients with other disabling somatic diseases. However, the data indicate that when psychopathology is present disabled patients with epilepsy are more likely to have psychotic illness than the other disabled patients.
目的
比较智力正常的癫痫残疾患者中非器质性精神障碍的患病率与年龄和性别相匹配的患有其他躯体疾病的残疾患者中类似精神障碍的患病率。
方法
在冰岛开展了一项病例对照研究，利用国家社会保障机构的现有信息，研究对象为领取残疾津贴的人群。1995年，冰岛有344名年龄在16至66岁（含）之间领取残疾津贴的癫痫患者。排除智力发育迟缓患者、自闭症患者和器质性精神病患者后，241例癫痫患者符合研究条件。对于每例病例，从所有患有心血管疾病、呼吸系统疾病或关节病且领取残疾津贴的患者中选取两名年龄和性别相匹配的对照。对对照应用与病例相同的排除标准。在两组患者中，精神科诊断分为以下四类之一：（1）精神病性疾病；（2）神经症性疾病或人格障碍；（3）酒精或药物依赖或滥用；（4）其他精神障碍。
结果
35%（85/241）的病例存在精神科诊断，而对照中这一比例为30%（143/482）（p = 0.15）。两组在不同精神科类别中的分布存在差异（p = 0.02）。这主要是由于病例组中患有精神病性疾病（尤其是精神分裂症或偏执状态）的男性过多。
结论
结果表明，智力正常的癫痫残疾患者中非器质性精神障碍的患病率与患有其他致残性躯体疾病的患者相比没有差异。然而，数据表明，当存在精神病理学情况时，癫痫残疾患者比其他残疾患者更有可能患有精神病性疾病。
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