Kokkonen E R, Kokkonen J, Saukkonen A L
Department of Child Psychiatry, University of Oulu, Finland.
Dev Med Child Neurol. 1998 Jun;40(6):364-8.
To assess whether juvenile-onset epilepsy or motor disability is complicated by an increased number of mental health disorders or experience of psychosomatic symptoms in young adulthood, we studied 81 subjects with epilepsy and 52 with motor disabilities at the age of 19 to 25 years and compared them with 211 controls. The main diagnostic tool, the Present State Examination, was administered to those attending the interviews in person who were of normal intelligence; there were 62, 38, and 123 subjects in the three categories, respectively. Compared with the controls, the subjects with epilepsy showed an equal prevalence of psychiatric disorders whereas those with motor disabilities had a significantly higher prevalence, particularly of depressive disorders. The reported prevalence of psychosomatic symptoms confirmed this main result. Psychological illness affected everyday life of two out of five subjects with motor disabilities, but only half of those in the other two groups. It is concluded that motor disability since childhood, but not epilepsy, could be a factor that increases susceptibility to psychiatric morbidity, especially depression, and causes a large number of psychosomatic symptoms. The results challenge staff of clinics working with such adolescents to find individual approaches in preventing the negative influence of psychological disorders on social life.
为了评估青少年期癫痫或运动障碍在成年早期是否会并发更多的心理健康问题或出现心身症状,我们研究了81名19至25岁的癫痫患者和52名运动障碍患者,并将他们与211名对照组进行比较。主要诊断工具《现状检查》应用于亲自参加访谈且智力正常的受试者;这三类受试者分别有62名、38名和123名。与对照组相比,癫痫患者的精神障碍患病率相当,而运动障碍患者的患病率显著更高,尤其是抑郁症。所报告的心身症状患病率证实了这一主要结果。心理疾病影响了五分之二的运动障碍患者的日常生活,但在其他两组中只有一半患者受影响。研究得出结论,童年起的运动障碍而非癫痫,可能是增加精神疾病易感性(尤其是抑郁症)并导致大量心身症状的一个因素。这些结果促使诊治此类青少年的诊所工作人员寻找个性化方法,以防止心理障碍对社交生活产生负面影响。