摘要目的 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.

abstractsObjective 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.