Motta E, Miller K, Rościszewska D, Kłosińska E
II Katedry i Kliniki Neurologii w Zabrzu.
Psychiatr Pol. 1998 Mar-Apr;32(2):199-208.
Depression is a significant problem in epilepsy. Suicides occur in epileptic patients five times more often than in general population. Material included 34 epileptics with 76 suicidal attempts and 24 patients with no history of suicide. Psychical state was studied with Beck Depression Inventory and Hamilton Depression Rating Scale. In the group with suicidal attempts 65% of patients had depression (54.5% of them had major depression) and in group without suicide attempts depression was noted in 54% (23% with major depression). Patients with depression were divided into two groups: group I with suicidal attempts and group II without history of suicide. In group I more patients were alcohol abusers (50% vs 31%), more were treated because of epilepsy longer than 10 years (59% vs 46%) and more had tonic-clonic seizures (82% vs 46%). In group I, 54% of patients were on polytherapy (more than half of them with fenobarbital). In group II, 31% of epileptics were on polytherapy (no one with fenobarbital). Major depression was significantly more frequent in epileptics with suicidal attempts. The severity of depression may influence the risk of suicide. Major depression may be associated with late age of onset of epilepsy, longer treatment duration, tonic-clonic seizures, polytherapy (mainly with fenobarbital) and alcohol abuse.
抑郁症是癫痫患者中的一个重要问题。癫痫患者自杀发生率比普通人群高五倍。研究资料包括34例有76次自杀未遂的癫痫患者和24例无自杀史的患者。采用贝克抑郁量表和汉密尔顿抑郁评定量表对精神状态进行研究。在有自杀未遂的患者组中,65%的患者患有抑郁症(其中54.5%为重度抑郁症),而在无自杀未遂的患者组中,54%的患者有抑郁症(23%为重度抑郁症)。患有抑郁症的患者被分为两组:第一组有自杀未遂,第二组无自杀史。在第一组中,酗酒者更多(50%对31%),因癫痫接受治疗超过10年的患者更多(59%对46%),全身性强直阵挛发作的患者更多(82%对46%)。在第一组中,54%的患者接受联合治疗(其中一半以上使用苯巴比妥)。在第二组中,31%的癫痫患者接受联合治疗(无人使用苯巴比妥)。有自杀未遂的癫痫患者中重度抑郁症明显更为常见。抑郁症的严重程度可能会影响自杀风险。重度抑郁症可能与癫痫发病年龄较晚、治疗时间较长、全身性强直阵挛发作、联合治疗(主要是使用苯巴比妥)以及酗酒有关。