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伴抑郁情绪癫痫患者的生活质量及其影响因素分析 |
王媚瑕1,奚晓雪2,桂千1,吴冠会1,朱伟1,沈明强1,侯晓夏1,赵慧敏1,谈心1,董晓峰1,徐勤荣1,程庆璋1,冯红选1* |
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(1. 南京医科大学附属苏州医院神经内科, 苏州 215000; 2. 南京医科大学附属苏州医院妇产科, 苏州 215000 *通信作者) |
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摘要: |
目的 探究伴抑郁情绪癫痫患者的生活质量及其影响因素。方法 选择2017年3月至2021年2月于南京医科大学附属苏州医院门诊及病房治疗的癫痫患者87例为研究对象。采用癫痫患者生活质量量表(QOLIE-31)、汉密尔顿抑郁量表-17(HAMD-17)、患者健康问卷躯体症状群量表(PHQ-15)、汉密尔顿焦虑量表(HAMA)分别评估患者的生活质量、抑郁情况、躯体症状数量和严重程度及焦虑情况。根据HAMD-17得分将患者分为伴抑郁情绪组(>17分,n=34)和对照组(≤17分,n=53;无抑郁和可能伴抑郁患者),比较两组患者的一般资料与量表评分。通过Spearman秩相关、Pearson相关、多重线性回归探究伴抑郁情绪癫痫患者生活质量的影响因素。结果 与对照组患者相比,伴抑郁情绪组患者中女性占比更高,癫痫发作频率更高,担忧癫痫发作的时间更长,治疗满意度更低,PHQ-15、HAMA得分均较高,QOLIE-31总分及癫痫发作担忧、情绪健康、精力/疲惫、综合生活质量维度得分均较低(P均<0.05)。相关分析显示,伴抑郁情绪癫痫患者的生活质量与抑郁情绪严重程度、焦虑严重程度、躯体症状数量和严重程度呈负相关(P均<0.01);多重线性回归分析显示,抑郁严重程度、躯体症状数量和严重程度对伴抑郁情绪癫痫患者的生活质量有影响,可解释生活质量总变异的65.4%(调整后R2=0.654,P<0.01)。结论 伴抑郁情绪癫痫患者的抑郁情绪严重程度、躯体症状数量和严重程度是其生活质量受损的重要因素,对其进行有效干预或可改善此类患者的生活质量。 |
关键词: 抑郁 癫痫 生活质量 躯体症状 |
DOI:10.16781/j.CN31-2187/R.20220251 |
投稿时间:2022-03-24修订日期:2022-11-14 |
基金项目:苏州市中西医结合科研基金(SKJYD2021223),苏州市“科教兴卫”青年科技项目(KJXW2019029),CAAE癫痫科研基金-UCB基金(2020004B). |
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Quality of life and its influencing factors in epilepsy patients with depression |
WANG Mei-xia1,XI Xiao-xue2,GUI Qian1,WU Guan-hui1,ZHU Wei1,SHEN Ming-qiang1,HOU Xiao-xia1,ZHAO Hui-min1,TAN Xin1,DONG Xiao-feng1,XU Qin-rong1,CHENG Qing-zhang1,FENG Hong-xuan1* |
(1. Department of Neurology, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou 215000, Jiangsu, China; 2. Department of Obstetrics and Gynaecology, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou 215000, Jiangsu, China *Corresponding author) |
Abstract: |
Objective To explore the quality of life and its influencing factors in epilepsy patients with depression. Methods A total of 87 epilepsy patients who were treated in the outpatient or ward of Suzhou Hospital Affiliated to Nanjing Medical University from Mar. 2017 to Feb. 2021 were selected. The quality of life in epilepsy-31 (QOLIE-31), Hamilton depression rating scale-17 (HAMD-17), patient health questionnaire-15 (PHQ-15), and Hamilton anxiety rating scale (HAMA) were used to evaluate the patients’ quality of life, depression, number and severity of somatic symptoms, and anxiety. According to the HAMD-17 score, the patients were divided into depression group (>17, n=34) and control (no depression or possible depression) group (≤17, n=53), the general information and scale scores of the 2 groups of patients were compared. Spearman rank correlation, Pearson correlation and multiple linear regression analyses were used to explore the influencing factors of quality of life in epilepsy patients with depression. Results Compared with the control group, the depression group had a higher proportion of females, more frequent seizures, longer period of worrying episodes, lower satisfaction with treatment, higher PHQ-15 and HAMA scores, and lower total QOLIE-31 score and scores of worry about seizures, emotional health, energy/fatigue and overall quality of life (all P<0.05). Correlation analysis showed that the quality of life of epilepsy patients with depression was negatively correlated with the severity of depression and anxiety, and the number and severity of somatic symptoms (all P<0.01). Multiple linear regression analysis showed that the severity of depression and the number and severity of somatic symptoms had impacts on the quality of life of epilepsy patients with depression, explaining 65.4% of the total variation in quality of life (adjusted R2=0.654, P<0.01). Conclusion The severity of depression and the number and severity of somatic symptoms are important factors for the impairment of quality of life in epilepsy patients with depression, and effective intervention may improve the quality of life of these patients. |
Key words: depression epilepsy quality of life somatic symptoms |