癫痫共病精神障碍住院患者的临床特征分析  

Clinical Features of Inpatients with Epilepsy Comorbided Mental Disorder

作　　者：罗炯[1,2,3,4] 陈旭 王雪 郑毅 

机构地区：[1]首都医科大学附属北京安定医院 [2]精神疾病诊断与治疗北京市重点实验室 [3]首都医科大学精神病学系 [4]北京市脑重大疾病研究院精神分裂症研究所,北京中国100088

出　　处：《中国健康心理学杂志》2014年第10期1477-1480,共4页China Journal of Health Psychology

摘　　要：目的对我院近两年来住院的癫痫患者进行回顾性研究,为规范治疗方案,改善预后提供循证依据。方法采用一般资料量表对50例患者住院资料进行整理,根据诊断与统计手册第五版(DSM-5).诊断系统对这类患者的病例记录资料进行规范诊断,分析临床特征。结果根据DSM-5诊断标准,癫痫脑病的比例明显下降(χ2=21.93,P<0.01),癫痫共病双相情感障碍的比例明显增加(χ2=23.51,P<0.01)。癫痫起病年龄越晚,共病双相情感障碍的可能性越大,差异有统计学意义(χ2=9.28,P<0.05);难治性癫痫共病双相情感障碍所占比例较非难治性癫痫共病双相情感障碍比例低(χ2=12.78,P<0.05);癫痫全面性发作共病双相情感障碍比例与部分性发作共病双相情感障碍比例无明显差异(χ2=11.67,P<0.05)。结论临床实践中癫痫脑病诊断过多,癫痫共病双相情感障碍诊断不足。癫痫患者共病双相情感障碍与癫痫的发作特征、发病年龄及抗癫痫治疗的效果有关。Objective To investigate the medical records of patients with epilepsy comorbided mental disorder ,and provide the evidence-based medicine data of the standard treatment and improved prognosis .Methods Collected the medical records of 50 patients using the General data scale ,Diagnosed the patients with DSM -5 diagnostic criteria .Analyzed the clinical features of the patients .Results According to the DSM -5 diagnostic criteria ,the proportion of epilepsy comorbided organic mental disorders decreased obviously （χ2 =21.93,P〈0.010,epilepsy comorbided bipolar disorder increased obviously （χ2 =23.51,P〈0.01）.The older age of onset in epilepsy , the higher risk of suffering bipolar disorder ,the differences were statistically significant （χ2 =9.28,P〈0.05）.The risks of refractory epi-lepsy comorbided bipolar disorder was low compared with non -refractory epilepsy（χ2 =12.78,P〈0.05）.There were no significant differences between the risk of generalized seizure epilepsy comorbided bipolar disorder and partial seizure epilepsy comorbided bipolar disorder（χ2 =11.67,P〈0.05）.Conclusion There is excessive diagnosis of epilepsy comorbided organic mental disorders and underdiagnosis of epilepsy comorbided bipolar disorder in clinical practice .Characteristics of epilepsy seizures ,age of onset and the effect of antiepileptic treatment are related to the epilepsy comorbided bipolar disorder .

关 键 词：癫痫 共病 精神障碍 双相情感障碍 

分 类 号：R473.74[医药卫生—护理学]