焦虑合并抑郁的初诊癫痫患者生活质量及影响因素的研究  

Analysis of quality of life and influencing factors in newly diagnosed epilepsy patients with co-morbid anxiety and depression

作　　者：徐寒冬 王吉平[2] XU Handong;WANG Jiping(Department of Neurology,Jinshan Hospital,Fudan University,Shanghai 201508,China;Department of Science and Education,Jinshan Hospital,Fudan University,Shanghai 201508,China)

机构地区：[1]复旦大学附属金山医院神经内科,上海201508 [2]复旦大学附属金山医院科教科,上海201508

出　　处：《癫痫杂志》2024年第2期97-103,共7页Journal of Epilepsy

基　　金：金山区癫病防治管理项目。

摘　　要：目的调查伴有焦虑和抑郁的初诊癫痫患者的生活质量状况及影响因素。方法采用方便采样选取2022年6月—2022年12月在上海复旦大学附属金山医院新诊断的180例癫痫患者作为研究对象,其中男113例、女67例,年龄18~92岁,平均(53.57±15.98)岁。使用癫痫生活质量量表-31项(Quality of life in epilepsy31,QOLIE-31)、汉密尔顿抑郁量表(Hamilton depression rating scale-24,HAMD-24)、汉密尔顿焦虑量表(Hamilton anxiety rating scale,HAMA)和癫痫自我管理量表(Epilepsy self-management scale,ESMS)评估患者的生活质量、抑郁水平、焦虑水平和自我管理能力。将患者分为焦虑合并抑郁组(HAMA≥14且HAMD>17)和对照组(HAMA<14且HAMD≤17),比较其一般特征和量表得分。使用Spearman相关分析、Pearson相关分析和多元线性回归分析确定合并抑郁的癫痫患者生活质量的影响因素。结果与对照组相比,合并焦虑与抑郁的老年患者比例较高,失业率较高,在过去一年中个人和家庭年收入较低,癫痫发作频率较高,药物依从性较低(P<0.05)。相关分析显示,癫痫患者伴有焦虑和抑郁的生活质量能力与焦虑和抑郁的严重程度呈负相关(r=−0.589,−0.620,P<0.05)。多元线性回归分析结果显示,过去一年中癫痫发作频率(β=−1.379,P<0.05)、焦虑的严重程度(β=−0.279,P<0.05)和抑郁的严重程度(β=−0.361,P<0.05)对合并焦虑和抑郁的癫痫患者生活质量能力产生影响。这些因素占生活质量的总变异的44.1%(R 2=0.4411,P<0.05)。结论焦虑合并抑郁的癫痫患者的近一年发作频率、焦虑及抑郁严重程度是其生活质量能力的重要影响因素,对于焦虑合并抑郁的癫痫患者,需要综合考虑这些因素,并为其提供相应的支持和干预。Objective To investigate the status of quality of life and influencing factors among newly diagnosed epilepsy patients with co-morbid anxiety and depression.Methods A total of 180 newly diagnosed epilepsy patients from June 2022 to December 2022 in a district of Shanghai were selected as the study subjects.The Quality of Life in Epilepsy-31(QOLIE-31),Hamilton Depression Rating Scale(HAMD-24),Hamilton Anxiety Rating Scale(HAMA),and Epilepsy SelfManagement Scale(ESMS)were used to assess patients'quality of life,depression levels,anxiety levels,and selfmanagement abilities,respectively.Patients were divided into the co-morbid depression group(HAMA≥14 and HAMD>17)and the control group(HAMA<14 and HAMD≤17),and their general characteristics and scale scores were compared.Spearman correlation,Pearson correlation,and multiple linear regression analysis were used to identify influencing factors of quality of life in epilepsy patients with co-morbid depression.Results Compared to the control group,the anxiety comorbid with depression group of older adults had a higher proportion,higher unemployment rate,lower personal and family annual income in the past year,higher frequency of epileptic seizures,and lower medication adherence(P<0.05).The correlational analysis revealed a negative correlation between the quality of life abilities of epilepsy patients with comorbid anxiety and depression and the severity of anxiety and depression.(r=−0.589,−0.620,P<0.05).The results of multiple linear regression analysis showed that the frequency of seizures in the past year(β=−1.379,P<0.05),severity of anxiety(β=−0.279,P<0.05),and severity of depression(β=−0.361,P<0.05)have an impact on the ability to quality of life in epilepsy patients with co-morbid anxiety and depression.These factors account for 44.1%of the total variability in quality of life(R 2=0.4411,P<0.05).Conclusion The frequency of seizures in the past year,as well as the severity of anxiety and depression,are important factors that influence the ability to q

关 键 词：癫痫 生活质量 焦虑 抑郁 影响因素 自我管理 

分 类 号：R749[医药卫生—神经病学与精神病学] R742.1[医药卫生—临床医学]