Depression and suicide attempt as risk factors for incident unprovoked seizures
Depression and suicide attempt as risk factors for incident unprovoked seizures
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DOI：
10.1002/ana.20685
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发表时间：
2006-01-01
影响因子：
11.2
通讯作者：
Kjartansson, O
中科院分区：
文献类型：
--
作者：
Hesdorffer, DC;Hauser, WA;Kjartansson, O
重度抑郁症已被证明会增加癫痫发生的风险，但以前的研究尚未评估这是否是由于抑郁症的特定症状。我们对冰岛儿童和10岁及以上成人中所有新诊断的无端癫痫发作进行了一项基于人群的病例对照研究，以检验重性抑郁症是无端癫痫发作和癫痫的危险因素这一假设，并解决抑郁症的特定症状是否导致这种风险增加。病例与人口登记处的下两个同性别出生相匹配。通过标准化的访谈，我们确定了抑郁症的症状，以进行诊断和统计手册第四版（DSM-IV）的诊断。有抑郁症史的病例比对照组多1.7倍（95%可信区间，1.1-2-7）。自杀未遂史在病例组中比对照组多5.1倍（95%置信区间，2.2-11-5）。即使在调整了年龄、性别、累积酒精摄入量和重度抑郁症或抑郁症症状数量后，自杀未遂也会增加癫痫发作的风险。重度抑郁症和自杀未遂独立地增加了无端癫痫发作的风险。这些数据表明，抑郁症和自杀企图可能是由于不同的潜在神经化学途径，其中每一个都是重要的癫痫的发展。
Major depression has been shown to increase the risk for development of epilepsy, but prior studies have not evaluated whether this is due to specific symptoms of depression. We conducted a population-based case-control study of all newly diagnosed unprovoked seizures among Icelandic children and adults aged 10 years and older to test the hypothesis that major depression is a risk factor for developing unprovoked seizure and epilepsy, and to address whether specific symptoms of depression account for this increased risk. Cases were matched to the next two same sex births from the population registry. Using standardized interviews, we ascertained symptoms of major depression to make a Diagnostic and Statistical Manual Fourth Edition (DSM-IV) diagnosis. A history of major depression was 1.7-fold more common among cases than among controls (95% confidence interval, 1.1-2-7). A history of attempted suicide was 5.1-fold more common among cases than among controls (95% confidence interval, 2.2-11-5). Attempted suicide increased seizure risk even after adjusting for age, sex, cumulative alcohol intake, and major depression or number of symptoms of depression. Major depression and attempted suicide independently increase the risk for unprovoked seizure. These data suggest that depression and suicide attempt may be due to different underlying neurochemical pathways, each of which is important in the development of epilepsy.