专题报道:抑郁症

癫痫患者共患抑郁和焦虑危险因素分析及其与生存质量的关系

  • 韩文杰 ,
  • 周友田 ,
  • 黎振声 ,
  • 康健捷 ,
  • 邓兵梅
展开
  • 中国人民解放军南部战区总医院神经内科 (广州 510010 )

收稿日期: 2023-11-02

  网络出版日期: 2024-03-08

基金资助

广东省医学科学技术研究基金项目(A2022402)

Risk factors of depression and anxiety in epilepsy patients and their relationship with quality of life

  • Wenjie HAN ,
  • Youtian ZHOU ,
  • Zhensheng LI ,
  • Jianjie KANG ,
  • Bingmei. DENG
Expand
  • Department of Neurology,General Hospital of Southern Theater Command,Guangzhou 510010,China

Received date: 2023-11-02

  Online published: 2024-03-08

摘要

目的 探讨成年癫痫患者共患抑郁和焦虑的危险因素及其与生活质量的关系。 方法 收集2022年5月至2023年1月神经内科诊断为癫痫、年龄≥18岁的患者。记录患者一般人口学资料及疾病相关信息。所有患者均进行生活质量、抑郁、焦虑量表测定。采用SPSS 26.0 软件分别进行多元线性回归分析、多元有序logistic回归分析、秩和检验、皮尔逊相关性分析等。 结果 111例患者中49.5%的患者存在抑郁,43.2%的患者存在焦虑。抑郁评分与焦虑评分与发作类型、发作频率、生活质量、右侧颞叶相关,生活质量评分与焦虑评分和抑郁评分均呈负相关(P < 0.01)。发作频率、发作类型、右侧颞叶是癫痫患者抑郁、焦虑的共同危险因素(P < 0.05)。 结论 癫痫共患病抑郁和焦虑受发作频率和发作类型等的影响,而这种不良的情绪进一步影响患者的生活质量。癫痫发作的偏侧化与抑郁和焦虑状态的存在之间目前还没发现有明确的联系。

本文引用格式

韩文杰 , 周友田 , 黎振声 , 康健捷 , 邓兵梅 . 癫痫患者共患抑郁和焦虑危险因素分析及其与生存质量的关系[J]. 实用医学杂志, 2024 , 40(4) : 460 -465 . DOI: 10.3969/j.issn.1006-5725.2024.04.004

Abstract

Objective To explore the risk factors of depression and anxiety in adult patients with epilepsy and their relationship with quality of life. Methods From May 2022 to January 2023, patients diagnosed with epilepsy (aged ≥ 18 years) in the department of neurology of our hospital were collected. General demographic data and disease?related information were recorded. Quality of life, depression and anxiety scales were measured in all patients. SPSS26.0 software was used for multiple linear regression analysis, multiple ordered Logistic regression analysis, rank sum test, Pearson correlation analysis, etc. Results Among the 111 patients, 49.5% had depression and 43.2% had anxiety. Depression score and anxiety score were correlated with attack type, attack frequency, quality of life and right temporal lobe, and there was a significant negative correlation between life quality score and anxiety and depression score (P < 0.01). Seizure frequency, seizure type and right temporal lobe were common risk factors for depression and anxiety in patients with epilepsy (P < 0.05). Conclusion Epileptic depression and anxiety were affected by seizure frequency and seizure type, and this bad mood further affected the quality of life of patients. No clear link has been found between the lateralization of seizures and the presence of depression and anxiety states, and further research is needed.

参考文献

1 KRISHNAN V. Depression and Anxiety in the Epilepsies: from Bench to Bedside[J]. Curr Neurol Neurosci Rep,2020,20(9):41. doi:10.1007/s11910-020-01065-z
2 李欣潞,许虹,梁稀.左乙拉西坦联合奥卡西平治疗成人颞叶癫痫患者认知功能障碍的疗效[J]. 实用医学杂志, 2021,37(1):87-90.. doi:10.3969/j.issn.1006-5725.2021.01.018
3 GULYAEVA N V. Stress-Associated Molecular and Cellular Hippocampal Mechanisms Common for Epilepsy and Comorbid Depressive Disorders[J]. Biochemistry (Mosc), 2021,86(6):641-656. doi:10.1134/s0006297921060031
4 RIBOT R, KANNER A M. Neurobiologic properties of mood disorders may have an impact on epilepsy: Should this motivate neurologists to screen for this psychiatric comorbidity in these patients?[J]. Epilepsy Behav, 2019,98(Pt B):298-301. doi:10.1016/j.yebeh.2019.01.026
5 LU E, PYATKA N, BURANT C J, et al. Systematic Literature Review of Psychiatric Comorbidities in Adults with Epilepsy[J]. J Clin Neurol, 2021,17(2):176-186. doi:10.3988/jcn.2021.17.2.176
6 TOLCHIN B, HIRSCH L J, LAFRANCE W C Jr. Neuropsychiatric aspects of epilepsy[J]. Psychiatr Clin North Am, 2020,43(2):275-290. doi:10.1016/j.psc.2020.02.002
7 VALENTE K D, BUSATTO FILHO G. Depression and temporal lobe epilepsy represent an epiphenomenon sharing similar neural networks: clinical and brain structural evidences[J]. Arq Neuropsiquiatr, 2013,71(3):183-190. doi:10.1590/s0004-282x2013000300011
8 PINBORG L H, J?RGENSEN M B. Depression and anxiety in adult patients with epilepsy[J]. Ugeskr Laeger, 2022,184(26):V03220195.
9 GUR-OZMEN S, MULA M, AGRAWAL N,et al. The effect of depression and side effects of antiepileptic drugs on injuries in patients with epilepsy[J]. Eur J Neurol, 2017,24(9):1135-1139. doi:10.1111/ene.13346
10 HESDORFFER D C, ISHIHARA L, WEBB D J, et al. Occurrence and Recurrence of Attempted Suicide Among People With Epilepsy[J]. JAMA Psychiatry, 2016,73(1):80-86. doi:10.1001/jamapsychiatry.2015.2516
11 GIAMBARBERI L, MUNGER CLARY H M. Suicide and Epilepsy[J]. Curr Neurol Neurosci Rep, 2022,22(8):441-450. doi:10.1007/s11910-022-01206-6
12 SVEINSSON O, ANDERSSON T, CARLSSON S,et al. The incidence of SUDEP: A nationwide population-based cohort study[J]. Neurology, 2017,89(2):170-177. doi:10.1212/wnl.0000000000004094
13 MULA M, COLEMAN H, WILSON S J. Neuropsychiatric and Cognitive Comorbidities in Epilepsy[J]. Continuum (Minneap Minn), 2022,28(2):457-482. doi:10.1212/con.0000000000001123
14 JOHN S E, TIMOTHY A P. 现代临床脑电图学 [M]. 北京:人民卫生出版社, 2009: 11-26.
15 中国抗癫痫协会. 临床诊疗指南癫痫病分册 (2015 修订版) [M]. 北京:人民卫生出版社, 2015: 55-63.
16 JANSEN C, FRANCOMME L, VIGNAL J P, et al. Interictal psychiatric comorbidities of drug-resistant focal epilepsy: Prevalence and influence of the localization of the epilepsy[J]. Epilepsy Behav, 2019,94:288-296. doi:10.1016/j.yebeh.2018.06.046
17 NOE K. Counseling and Management of the Risks of Living With Epilepsy[J]. Continuum (Minneap Minn), 2019,25(2):477-491. doi:10.1212/con.0000000000000708
18 GILLAM F. Optimizing epilepsy management: seizure control, reduction, tolerability, and co-morbidities. Introduction[J]. Neurology, 2002,58(8 ):S1. doi:10.1212/wnl.58.8_suppl_5.s1
19 AMRUTH G, PRAVEEN-KUMAR S, NATARAJU B, et al. Study of psychiatric comorbidities in epilepsy by using the Mini International Neuropsychiatric Interview[J]. Epilepsy Behav,2014,33:94-100. doi:10.1016/j.yebeh.2014.02.001
20 VUJISI? S, VODOPI? S, RADULOVI? L, et al. Psychiatric comorbidities among patients with epilepsy in Montenegro[J]. Acta Clin Croat, 2014,53(4):411-416.
21 MICULAUD-FRANCHI J A, BARTOLOMEI F, DUNCAN R, et al. Evaluating quality of life in epilepsy: The role of screening for adverse drug effects, depression, and anxiety[J]. Epilepsy Behav, 2017,75:18-24. doi:10.1016/j.yebeh.2017.07.016
22 RADAELLI G, MAJOLO F, LEAL-CONCEI??O E, et al. Left Hemisphere Lateralization of Epileptic Focus Can Be More Frequent in Temporal Lobe Epilepsy Surgical Patients with No Consensus Associated with Depression Lateralization[J]. Dev Neurosci, 2021,43(1):1-8.
23 MAIZULIANA H, USUI N, TERADA K, et al. Clinical, semiological, electroencephalographic, and neuropsychological features of "pure" neocortical temporal lobe epilepsy[J]. Epileptic Disord, 2020,22(1):55-65.
24 RODIN E A, KATZ M, LENNOX K. Differences between patients with temporal lobe seizures and those with other forms of epileptic attacks[J]. Epilepsia, 1976,17(3):313-320. doi:10.1111/j.1528-1157.1976.tb03409.x
25 PRAYSON B E, FLODEN D P, FERGUSON L, et al. Effects of surgical side and site on psychological symptoms following epilepsy surgery in adults[J]. Epilepsy Behav, 2017,68:108-114. doi:10.1016/j.yebeh.2016.11.004
26 VINTI V, DELL'ISOLA G B, TASCINI G, et al. Temporal Lobe Epilepsy and Psychiatric Comorbidity[J]. Front Neurol, 2021,12:775781. doi:10.3389/fneur.2021.775781
27 BERG A T, ALTALIB H H, DEVINSKY O. Psychiatric and behavioral comorbidities in epilepsy: A critical reappraisal[J]. Epilepsia, 2017,58(7):1123-1130. doi:10.1111/epi.13766
28 FREBERG E, TAGLIALATELA G. Exercise as a Potential Therapeutic Strategy to Target the Clinical Link Between Depression and Alzheimer's Disease: A Narrative Review[J]. J Alzheimers Dis, 2022,89(3):759-767. doi:10.3233/jad-210632
29 PLOSSER M, MCDONALD C, HIRSHMAN B, et al. Psychiatric outcomes after temporal lobe surgery in patients with temporal lobe epilepsy and comorbid psychiatric illness: A systematic review and meta-analysis[J]. Epilepsy Res, 2023,189:107054. doi:10.1016/j.eplepsyres.2022.107054
30 HIGRAY C, MCGONIGAL A, KOTWAS I, et al. The Relationship Between Epilepsy and Anxiety Disorders[J]. Curr Psychiatry Rep, 2019,21(6):40. doi:10.1007/s11920-019-1029-9
31 KANNER A M, MAZARATI A, KOEPP M. Biomarkers of epileptogenesis: psychiatric comorbidities (?)[J]. Neurotherapeutics, 2014,11(2):358-372. doi:10.1007/s13311-014-0271-4
32 KANER A M, SCHARFMAN H, JETTE N, et al. Epilepsy as a Network Disorder (1): What can we learn from other network disorders such as autistic spectrum disorder and mood disorders? [J]. Epilepsy Behav, 2017,77:106-113. doi:10.1016/j.yebeh.2017.09.014
33 BASU T, MAGUIRE J, SALPEKAR J A. Hypothalamic-pituitary-adrenal axis targets for the treatment of epilepsy[J]. Neurosci Lett, 2021,746:135618. doi:10.1016/j.neulet.2020.135618
34 TROUBAT R, BARONE P, LEMAN S, et al. Neuroinflammation and depression: A review[J]. Eur J Neurosci, 2021,53(1):151-171. doi:10.1111/ejn.14720
35 WULSIN A C, FRANCO-VILLANUEVA A, ROMANCHECK C, et al. Functional disruption of stress modulatory circuits in a model of temporal lobe epilepsy[J]. PLoS One, 2018,13(5):e0197955. doi:10.1371/journal.pone.0197955
36 MASOURI A, FALLAH A, VALIANTE T A. Determining surgical candidacy in temporal lobe epilepsy[J]. Epilepsy Res Treat,2012,2012:706917. doi:10.1155/2012/706917
文章导航

/