正规抗癫痫治疗与老年癫痫患者抑郁情绪的相关性研究
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摘要
目的观察抗癫痫药物规范化治疗后,老年患者抑郁状态的变化。方法选择2011年1月1日~12月31日在台州市第一人民医院就诊的初诊或未曾规范化治疗的≥65岁的癫痫患者45例,男性19例,女性26例,收集患者基本资料及汉密尔顿抑郁量表(Hamilton depression scale,HAMD)评分,根据HAMD评分分为抑郁组14例,非抑郁组31例,患者进行规范化抗癫痫治疗,随访2年,再次评定HAMD评分,并收集相关资料。结果抑郁组患者治疗前HAMD评分[(21.14±3.66)分vs(12.19±3.00)分]及癫痫发作频率[(2.39±0.96)次/月vs(1.39±0.68)次/月]均明显高于非抑郁组(P=0.00)。2年正规用药后,抑郁组HAMD评分高于非抑郁组[(18.00±3.26)分vs(12.09±2.68)分,P=0.00],2组癫痫发作频率无显著差异[(0.05±0.12)次/月vs(0.07±0.18)次/月,P=0.73],抑郁组8例HAMD评分下降为正常(P<0.05),6例仍抑郁患者HAMD评分较治疗前下降,但无明显差异(P>0.05)。Spearman相关分析显示,治疗前HAMD评分及治疗前癫痫发作频率与抑郁改善呈正相关(r=0.77、0.55,P=0.00)。结论正规抗癫痫治疗能良好控制癫痫发作情况,并明显改善患者抑郁情绪,帮助恢复社会功能。治疗前癫痫发作越频繁,抑郁程度越重患者改善越明显。
Objective To study the change of depression in elderly epilepsy patients after treated with antiepileptic drugs.Methods Forty-five epilepsy patients(19males nd 26females)aged ≥65years admitted to our hospital from 2011-01-01 to 2011-12-01 were included in this study.Their basic information and HAMD score were recorded.The patients were divided into depression group(n=14)and depression-free group(n=31)according to their HAMD score.After the patients were treated with antiepiletic drugs and followed up for two years,their HAMD score and related data were recorded.Results The HAMD score and frequency of seizure each month were significantly higher in depression group than in depression-free group(21.14±3.66 vs 12.19±3.00,2.39±0.96 vs 1.39±0.68,P=0.00).The number of depression patients was reduced to 6after 2-year treatment(P<0.05).Spearman correlation analysis showed that the HAMD score and frequency of seizure before treatment were positively correlated with the improvment of depression(r=0.77,r=0.55,P=0.00).Conclusion Antiepileptic therapy can effectively control seizures and improve depression in elderly epilepsy patients,thus helping them to restore their social functions.The higher the frequency of seizure is and the severer the depression is before treatment,the better the improvement of depression is.
Objective To study the change of depression in elderly epilepsy patients after treated with antiepileptic drugs.Methods Forty-five epilepsy patients(19males nd 26females)aged ≥65years admitted to our hospital from 2011-01-01 to 2011-12-01 were included in this study.Their basic information and HAMD score were recorded.The patients were divided into depression group(n=14)and depression-free group(n=31)according to their HAMD score.After the patients were treated with antiepiletic drugs and followed up for two years,their HAMD score and related data were recorded.Results The HAMD score and frequency of seizure each month were significantly higher in depression group than in depression-free group(21.14±3.66 vs 12.19±3.00,2.39±0.96 vs 1.39±0.68,P=0.00).The number of depression patients was reduced to 6after 2-year treatment(P<0.05).Spearman correlation analysis showed that the HAMD score and frequency of seizure before treatment were positively correlated with the improvment of depression(r=0.77,r=0.55,P=0.00).Conclusion Antiepileptic therapy can effectively control seizures and improve depression in elderly epilepsy patients,thus helping them to restore their social functions.The higher the frequency of seizure is and the severer the depression is before treatment,the better the improvement of depression is.
引文
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[15]Peng WF,Ding J,Li X,Mao LY,Wang X.Clinical risk factors for depressive symptoms in patients with epilepsy.Acta Neurol Scand,2014,129:343-349.
[16]Seo JG,Kim JM,Park SP.Perceived stigma is a critical factor for interictal aggression in people with epilepsy.Seizure,2015,26:26-31.
[17]Yeni K,Tulek I,Bebek N.Factors associated with perceived stigma among patients with epilepsy in Turkey.Epilepsy Behav,2016,60:142-148.
[18]Zis P,Yfanti P,Siatouni A,et al.Determinants of depression among patients with epilepsy in Athens,Greece.Epilepsy Behav,2014,33:106-109.
[2]Gu L,Liang B,Chen Q,etal.Prevalence of epilepsy in the Peoples Republic of China:a systematic review.Epilepsy Res,2013,105:195-205.
[3]Hu J,Si Y,Zhou D,etal.Prevalence and treatment gap of active convulsive epilepsy:a large community-based survey in rural West China.Seizure,2014,23:333-337.
[4]Leppik IE,Birnbaum AK.Epilepsy in the elderly.Ann NY Acad Sci,2010,1184:208-224.
[5]Kaiboriboon K,Bakaki PM,Lhatoo SD,et al.Incidence and prevalence of treated epilepsy among poor health and low-income Americans.Neurology,2013,80:1942-1949.
[6]SillanpM,Lastunen S,Helenius H,etal.Regional differences and secular trends in the incidence of epilepsy in Finland:a nationwide 23-year registry study.Epilepsia,2011,52:1857-1867.
[7]Dong Y,Huang F,Hu G,et al.The prevalence of suicidal ideation among the elderly in China:a meta-analysis of 11crosssectional studies.Compr Psychiatry,2014,55:1100-1105.
[8]Kanner AM.Management of psychiatric and neurological comorbidit-ies in epilepsy.Nat Rev Neurol,2016,12:106-116.
[9]Dias R,Batewan LM,Farias ST,et al.Depression in epilepsy is associated with lack of seizure control.Epilepsy Behav,2010,19:445-447.
[10]Chen HF,Tsai YF,Hsi MS,et al.Factors affecting quality of life in adults with epilepsy in Taiwan:a cross-sectional,correlational study.Epilepsy Behav,2016,58:26-32.
[11]Ayanda KA,Sulyman D.The predictors of psychiatric disorders among people living with epilepsy as seen in a Nigerian tertiary health institution.Niger Med J,2016,57:24-30.
[12]Kwon OY,Park SP.Depression and anxiety in people with epilepsy.J Clin Neurol,2014,10:175-188.
[13]Kampf C,Walter U,Rsche J.The impact of anxiety,seizure severity,executive dysfunction,subjectively perceived psychological deficits,and depression on social function in patients with epilepsy.Epilepsy Behav,2016,57:5-8.
[14]鲁文莉,徐大斌,李冬雪,等.癫痫患者伴发抑郁症的临床研究.罕少疾病杂志,2008,15,29-30.
[15]Peng WF,Ding J,Li X,Mao LY,Wang X.Clinical risk factors for depressive symptoms in patients with epilepsy.Acta Neurol Scand,2014,129:343-349.
[16]Seo JG,Kim JM,Park SP.Perceived stigma is a critical factor for interictal aggression in people with epilepsy.Seizure,2015,26:26-31.
[17]Yeni K,Tulek I,Bebek N.Factors associated with perceived stigma among patients with epilepsy in Turkey.Epilepsy Behav,2016,60:142-148.
[18]Zis P,Yfanti P,Siatouni A,et al.Determinants of depression among patients with epilepsy in Athens,Greece.Epilepsy Behav,2014,33:106-109.