中华儿科杂志
中華兒科雜誌
중화인과잡지
Chinese Journal of Pediatrics
2010年
5期
346-350
,共5页
陈倩%闫秀贤%尚宁秀%张桂榛%高志杰%王扬%李尔珍%杨健%许克铭
陳倩%閆秀賢%尚寧秀%張桂榛%高誌傑%王颺%李爾珍%楊健%許剋銘
진천%염수현%상저수%장계진%고지걸%왕양%리이진%양건%허극명
情绪障碍%行为障碍%共病现象%生活质量%癫癎%儿童
情緒障礙%行為障礙%共病現象%生活質量%癲癎%兒童
정서장애%행위장애%공병현상%생활질량%전간%인동
Mood disorders%Conduct disorder%Comorbidity%Quality of life%Epilepsy%Child
目的 观察癫癎患儿的抑郁、焦虑障碍、注意缺陷多动障碍(ADHD)症状的共患率,分析相关影响因素及其对患儿生活质量的影响.方法 对142例8~16岁不同类型癫癎患儿进行神经心理评估,对100例正在服药的患儿进行美国癫癎患者生活质量量表(QOLIE-31)问卷测试,观察共患情绪、行为障碍状况及影响因素.结果 (1)癫癎患儿情绪、行为障碍症状的共患率:142例癫癎患儿,共患一种或以上情绪、行为障碍者82例,占57.7%,其中抑郁、焦虑障碍及ADHD症状患病率分别为14.8%、44.4%及17.6%.(2)情绪、行为共患病的影响因素:共患病与性别、年龄及与癫癎疾病相关诸因素均无明显相关,共患病间存在相互影响.(3)共患病对癫痫患儿生活质量的影响:共患病组患儿总的生活质量及7个分项的分值均明显低于无共患病组(P<0.05).结论 癫癎儿童的抑郁、焦虑障碍及ADHD共患率颇高,与性别、年龄及癫癎疾病相关诸因素无明显相关,共患病间可互为影响因素,共患病是导致癫癎患儿生活质量低下的重要因素之一,故应对癫癎患儿进行全面的神经心理评估,在控制发作的同时治疗共患的情绪、行为障碍,以提高癫癎患儿的生活质量.
目的 觀察癲癎患兒的抑鬱、焦慮障礙、註意缺陷多動障礙(ADHD)癥狀的共患率,分析相關影響因素及其對患兒生活質量的影響.方法 對142例8~16歲不同類型癲癎患兒進行神經心理評估,對100例正在服藥的患兒進行美國癲癎患者生活質量量錶(QOLIE-31)問捲測試,觀察共患情緒、行為障礙狀況及影響因素.結果 (1)癲癎患兒情緒、行為障礙癥狀的共患率:142例癲癎患兒,共患一種或以上情緒、行為障礙者82例,佔57.7%,其中抑鬱、焦慮障礙及ADHD癥狀患病率分彆為14.8%、44.4%及17.6%.(2)情緒、行為共患病的影響因素:共患病與性彆、年齡及與癲癎疾病相關諸因素均無明顯相關,共患病間存在相互影響.(3)共患病對癲癇患兒生活質量的影響:共患病組患兒總的生活質量及7箇分項的分值均明顯低于無共患病組(P<0.05).結論 癲癎兒童的抑鬱、焦慮障礙及ADHD共患率頗高,與性彆、年齡及癲癎疾病相關諸因素無明顯相關,共患病間可互為影響因素,共患病是導緻癲癎患兒生活質量低下的重要因素之一,故應對癲癎患兒進行全麵的神經心理評估,在控製髮作的同時治療共患的情緒、行為障礙,以提高癲癎患兒的生活質量.
목적 관찰전간환인적억욱、초필장애、주의결함다동장애(ADHD)증상적공환솔,분석상관영향인소급기대환인생활질량적영향.방법 대142례8~16세불동류형전간환인진행신경심리평고,대100례정재복약적환인진행미국전간환자생활질량량표(QOLIE-31)문권측시,관찰공환정서、행위장애상황급영향인소.결과 (1)전간환인정서、행위장애증상적공환솔:142례전간환인,공환일충혹이상정서、행위장애자82례,점57.7%,기중억욱、초필장애급ADHD증상환병솔분별위14.8%、44.4%급17.6%.(2)정서、행위공환병적영향인소:공환병여성별、년령급여전간질병상관제인소균무명현상관,공환병간존재상호영향.(3)공환병대전간환인생활질량적영향:공환병조환인총적생활질량급7개분항적분치균명현저우무공환병조(P<0.05).결론 전간인동적억욱、초필장애급ADHD공환솔파고,여성별、년령급전간질병상관제인소무명현상관,공환병간가호위영향인소,공환병시도치전간환인생활질량저하적중요인소지일,고응대전간환인진행전면적신경심리평고,재공제발작적동시치료공환적정서、행위장애,이제고전간환인적생활질량.
Objective To find out the rate of comorbidities of depression, anxiety disorder and attention deficit hyperactivity disorder (ADHD) symptoms in children with epilepsy and to analyze the relevant affecting factors and impacts on quality of life. Method Totally 142 children with various types of epilepsy underwent neuropsychological assessment with the Depression Self-rating Scale for Children, the Screen for Child Anxiety Related Emotional Disorders and the ADHD Rating Scale-Ⅳ, an 18-item parent-rated questionnaire based on the diagnostic criteria for ADHD, the quality of life was measured in 100 cases on antiepileptic medications by the Quality of Life in Epilepsy Inventory (QOLIE-31). The comorbidity rates were calculated using t-test, χ~2 test and multiple logistic analysis, the variables associated with psychiatric comorbidities were determined, and the impact on quality of life was analyzed. Result (1) The total rate of emotional and behaviral comorbidities was 57.7% (82/142), the frequency of depressive disorder, anxiety disorder and ADHD was 14.8%, 44.4% and 17.6%, respectively. The suicidal ideation occasionally occurred in 5.6% of the cases and 0.7% of cases often had the ideation, but no suicidal action was found in any case. (2)Risk factors for the emotional and behaviral disorders: multiple logistic analysis indicated that age, gender and epilepsy illness-related variables were not relative to the comorbidities, P >0.05 ,there were interactions among the disorders. (3) The impact on the quality of life: The emotional and behaviral conditions were associated with the low quality of life, which was significantly lower in epileptic children with co-morbid disorder compared to non-comorbidities epilepsy group. Especially negative impact on the total score of quality of life and four sub-items such as overall quality, emotional well-being, cognitive and social function, P <0.001. There were also significant differences between the two groups in the other three sub-items including fear for seizure attack, energy/fatigue and medication affects (P < 0.05). Conclusions The frequency of emotional and behaviral disorders including depress disorder, anxiety disorder and ADHD was considerably high in children with epilepsy. Age, gender and epilepsy illness-related variables are not associated with the emotional and behavioral comorbidifies, which interfere with each other. Emotional and bebeviral disorder is one of the negative factors to the quality of life in epileptic patients. Neuropsychological assessment and treatment are important for improvement of the quality of life in children with epilepsy.