癫痫儿童共患抑郁障碍及其与生态学执行功能的相关性研究  

Depression in children with epilepsy: association with ecological executive function

作　　者：陈灵艳 秦艳 代梦瑶 张婷[1] 沈业茹 周农[1] Chen Lingyan;Qin Yan;Dai Mengyao(Dept of Neurology,The First Affiliated Hospital of Anhui Medical University,Hefei 230022)

机构地区：[1]安徽医科大学第一附属医院神经内科,合肥230022

出　　处：《安徽医科大学学报》2020年第3期442-446,共5页Acta Universitatis Medicinalis Anhui

基　　金：安徽省高校省级自然科学研究项目(编号:KJ2012A175)。

摘　　要：目的研究癫痫儿童的抑郁情况及生态学执行功能损害特点并探讨两者之间的相关性。方法选取51例癫痫儿童和48例健康儿童作为受试对象,采用儿童抑郁量表(CDI)和执行功能行为评定量表家长问卷(BRIEF)分别对其进行评估,癫痫组患儿根据CDI评分等条件划分为癫痫共患抑郁障碍组及癫痫不伴抑郁障碍组,进一步比较两组间的BRIEF结果。结果①癫痫儿童共患抑郁障碍比例为31.37%,高于对照组(P<0.05)。②癫痫组BRIEF量表总分(GEC)及行为管理指数(BRI)、元认知指数(MI)两个维度得分分别为[(54.10±9.64)分、51(44,58)分、(55.00±8.84)分]高于对照组[(43.83±6.86)分、41(40,44)分、(45.83±7.26)分],差异有统计学意义(P<0.05);癫痫共患抑郁障碍组BRIEF量表得分高于癫痫不伴抑郁障碍组,差异有统计学意义(P<0.05)。③多元逐步回归分析显示癫痫儿童抑郁与癫痫发作有效控制成负相关,BRIEF总分与药物种类数成正相关,与发作有效控制成负相关(P<0.05)。④相关性分析结果显示BRIEF总分、BRI、MI及其所属因子与抑郁成不同程度的正相关(r=0.385~0.597,P<0.05)。结论癫痫儿童存在抑郁障碍和执行功能损害;共患抑郁障碍的癫痫患儿生态学执行功能损害更明显;癫痫患儿的抑郁程度与生态学执行功能损害严重程度相关。Objective To investigate the depressive state and the features of ecological executive function in children with epilepsy and explore the relationship between depression and executive function. Methods The research recruited 51 children with epilepsy as the experimental subjects and 48 typically developing children as control subjects. Both groups completed Children’s Depression Inventory(CDI) and Behavior Rating Inventory of Executive Function(BRIEF). The children with epilepsy were divided into two groups according to the CDI scores: epilepsy with depression and epilepsy without depression. The BRIEF scores between the two groups were compared. Results ① Of all 51 children with epilepsy,16 had depression, resulting in a comorbidity rate of 31.37%, which is significantly higher than the control group(P<0.05). ② The scores of Global Executive Composite(GEC), Behavioral Regulation Index(BRI) and Metacognition Index(MI) of BRIEF [(54.10±9.64), 51(44,58),(55.00±8.84)] were significantly higher than those of the control group [(43.83±6.86), 41(40,44),(45.83±7.26)] respectively(P<0.05). ③ Multiple stepwise regression analysis showed that depression in children with epilepsy was negatively correlated with the effective control of epileptic seizure, and GEC was positively correlated with the number of drug types, and negatively correlated with the effective control of seizure(P<0.05). ④ Pearson’s correlation test showed that the scores of BRIEF(including GEC, BRI, MI and all sub factors) had significantly positive correlations with the score of depression(r=0.385~0.597, P<0.05). Conclusion Children with epilepsy have depressive disorder and executive dysfunction compared with healthy controls. The patients with epilepsy and depression show more serious impairments of ecological executive function than those do not have depression. Depression and executive function in children with epilepsy have significant correlations.

关 键 词：癫痫 抑郁 执行功能 

分 类 号：R741[医药卫生—神经病学与精神病学] R749[医药卫生—临床医学]