摘要目的:评估新型冠状病毒肺炎（COVID-19）暴发时武汉市及其周边城市癫痫患者的心理睡眠状况及其影响因素。方法:于2020年2月23日至3月5日对2019年4月1日至2020年1月20日就诊于华中科技大学同济医学院附属同济医院癫痫中心的570例癫痫患者进行网络问卷调查（调查项目包括人口学特征、癫痫发作情况），评估量表采用广泛性焦虑量表-7、患者健康问卷-9、失眠严重程度指数量表，应用SPSS 22.0统计学软件对癫痫患者的人口学特征、癫痫发作情况、COVID-19疫情的感知威胁与精神共患病（抑郁、焦虑和失眠）进行相关性分析。结果:最终纳入362份有效问卷进行分析（应答率63.51%，362/570），分别有34例（9.4%）、47例（13.0%）、71例（19.6%）癫痫患者存在焦虑、抑郁和失眠。疫情前癫痫发作频率≥2次/月（ OR=3.395，95% CI 1.561~7.384， P=0.002）、疫情期间主观生活质量差（ OR=10.753，95% CI 1.938~59.654， P=0.024）、中等及以上担心疫情对癫痫造成影响（ OR=3.077，95% CI 1.382~6.853， P=0.006）的患者更易焦虑；疫情期间主观生活质量差（ OR=6.188，95% CI 1.317~29.079， P=0.021）的患者更易抑郁；有子女（ OR=3.090，95% CI 1.759~5.431， P<0.001）、有COVID-19相关症状（ OR=3.609，95% CI 1.674~7.778， P=0.001）、疫情前癫痫发作频率≥2次/月（ OR=1.907，95% CI 1.017~3.575， P=0.044）和中等及以上程度担心癫痫再次发作（ OR=2.555，95% CI 1.370~4.764， P=0.003）的患者更易失眠。 结论:在COVID-19疫情期间，部分癫痫患者存在焦虑、抑郁和失眠。主观生活质量差、疫情前癫痫发作频率高、过度担心疫情对癫痫造成影响和过度担心癫痫发作的患者容易出现焦虑、抑郁和失眠。

abstractsObjective:To evaluate the status and influencing factors of psychiatric comorbidities of patients with epilepsy (PWEs) in Hubei province during the outbreak of COVID-19.Methods:From February 23, 2020 to March 5, 2020, a network questionnaire survey (including demographic characteristics, seizures, Generalized Anxiety Disorder Scale-7 score, Patient Health Questionnaire-9 score, Insomnia Severity Index score) was conducted among 570 PWEs who visited the Epilepsy Center of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology during April 1, 2019 and January 20, 2020. SPSS 22.0 software was used for correlation analysis of sociodemographic characteristics, epilepsy related factors, perceived threat to the COVID-19 and psychiatric comorbidity (depression, anxiety and insomnia) of PWEs during the COVID-19 epidemic.Results:A total of 362 valid questionnaires were included for analysis (the response rate was 63.51%,362/570). Thirty-four (9.4%), forty-seven (13.0%) and seventy-one (19.6%) patients suffered from anxiety, depression and insomnia, respectively. Patients with seizure frequency ≥2 times/month before the epidemic ( OR=3.395,95% CI 1.561-7.384, P=0.002), poor subjective quality of life during the epidemic ( OR=10.753,95% CI 1.938-59.654, P=0.024), and moderate to severe worry about bad impact of the epidemic on epilepsy ( OR=3.077, 95% CI 1.382-6.853, P=0.006) were more likely to be anxious. Patients with poor subjective quality of life during the epidemic ( OR=6.188, 95% CI 1.317-29.079, P=0.021) were more likely to be depressed. Patients with COVID-19 related symptoms ( OR=3.609, 95% CI 1.674-7.778, P=0.001), children ( OR=3.090, 95% CI 1.759-5.431, P<0.001), seizure frequency ≥2 times/month before the epidemic ( OR=1.907, 95% CI 1.017-3.575, P=0.044), and moderate to severe worry about unanticipated seizures ( OR=2.555, 95% CI 1.370-4.764, P=0.003) were more likely to suffer from insomnia. Conclusions:During the COVID-19 epidemic, parts of PWEs suffered from anxiety, depression and insomnia. PWEs with poor subjective quality of life, high frequency of epileptic seizures before the epidemic, excessive worry about bad impact of the epidemic on epilepsy and excessive worry about unanticipated seizures were prone to anxiety, depression and insomnia.