CAJ | 학술논문

抑郁是癫癎患者合并的最常见的精神障碍，约1/3的癫患者曾出现抑郁症状。抑郁和癫存在相关联的病理和解剖机制，如神经递质异常和海马萎缩，使得癫和抑郁在临床上的关联性有了病理和解剖基础。中国没有癫患者合并抑郁的诊断标准，建议使用NDDI-E量表或其他抑郁症筛查量表进行筛查。对于抑郁症状明确，且持续时间>2周的患者予以转诊精神科。抑郁症治疗建议应用抗抑郁药物，而不是具有心境稳定作用的抗癫药物，一线治疗推荐5-羟色胺再摄取抑制剂、5-羟色胺去甲肾上腺素再摄取抑制剂和三环类抗抑郁药。非药物疗法如电休克治疗和认知治疗的疗效尚不肯定。
억욱시전간환자합병적최상견적정신장애，약1/3적전환자증출현억욱증상。억욱화전존재상관련적병리화해부궤제，여신경체질이상화해마위축，사득전화억욱재림상상적관련성유료병리화해부기출。중국몰유전환자합병억욱적진단표준，건의사용NDDI-E량표혹기타억욱증사사량표진행사사。대우억욱증상명학，차지속시간>2주적환자여이전진정신과。억욱증치료건의응용항억욱약물，이불시구유심경은정작용적항전약물，일선치료추천5-간색알재섭취억제제、5-간색알거갑신상선소재섭취억제제화삼배류항억욱약。비약물요법여전휴극치료화인지치료적료효상불긍정。
Depression is the most common psychiatric comorbidity in patients with epilepsy, about 1/3 of epilepsy patients had symptoms of depression. Depression and epilepsy have associated pathological and anatomical mechanisms, such as neurotransmitter abnormalities and hippocampal atrophy, which is a base to explain the high relevance of epilepsy and depression. In China, we have no diagnostic criteria for depression in patients with epilepsy. It is recommended to use NDDI-Escale or other depression screening scale when screening depressive symptoms in patients with epilepsy. For patients who had clear depressive symptoms lasting longer than two weeks, a transfer to psychiatric clinic is recommended. In depression treatment, SSRI, SNRI and tricyclic antidepressants are recommended, rather than antiepileptic drugs which have mood-stabilizing effect. The efifciency of non-drug treatments are uncertain, such as electroconvulsive therapy and cognitive therapy in patients with epilepsy.