Which factors may play a pivotal role on determining the type of psychiatric disorder in children and adolescents with epilepsy?
Which factors may play a pivotal role on determining the type of psychiatric disorder in children and adolescents with epilepsy?
复制标题
DOI：
10.1016/j.yebeh.2004.09.001
复制
发表时间：
2004-12-01
影响因子：
2.6
通讯作者：
Valente, KD
中科院分区：
文献类型：
--
作者：
Thome-Souza, S;Kuczynski, E;Valente, KD
医生们已经意识到儿童和青少年癫痫患者中精神疾病（pd）的高患病率；然而，对于哪些因素可能在不同类型的PD中起重要作用，存在许多争议。本研究旨在评估主要PD；验证发病年龄与PD诊断年龄的比较；并确定哪些因素可能与所描述的PD类型相关。为此，一个多学科团队评估了患有癫痫的儿童和青少年（4-18岁），并分析了患者相关因素，如年龄（根据Piaget的认知量表分组：13岁）、性别、pd家族史和认知状况。关于癫痫的特征，我们考虑了发病年龄、持续时间、精神科评估时的癫痫控制、难治性、抗癫痫药物（单药vs多药）、癫痫类型（全发性vs局灶性）和癫痫类型（特发性vs症状性/可能症状性）。抑郁症发生率为36.4%，注意缺陷多动障碍（ADHD）发生率为29.1%，这是本系列中最常见的pd。局灶性癫痫在儿童和青少年pd患者中更为常见。在PD类型方面，年龄是一个重要的影响因素，儿童以ADHD为主，青少年以抑郁症为主（P < 0.0001）。家族史对抑郁症有影响，但对其他pd无影响（P < 0.0001）。在更长时间内，抑郁症仍未得到充分诊断和治疗。早期诊断和治疗的影响尚不清楚。(C) 2004爱思唯尔公司版权所有。
Physicians have become aware of the high prevalence of psychiatric disorders (PDs) in children and adolescents with epilepsy; however, there are many controversies as to which factors may have an important role in the different types of PD. This study was designed to assess the main PD; verify the age of onset compared with the age of diagnosis of the PD; and determine which factors may be correlated with the type of PD described. For this purpose, a multidisciplinary team evaluated children and adolescents (4-18 years) with epilepsy and analyzed patient-related factors such as age (grouped according to Piaget's cognitive scale: 13 years), sex, family history of PDs, and cognitive status. With respect to epilepsy features, we considered age of onset, duration, seizure control at the time of psychiatric evaluation, refractoriness, antiepileptic drugs (mono- vs polytherapy), seizure type (generalized vs focal), and epilepsy type (idiopathic vs symptomatic/probably symptomatic). Depression occurred in 36.4% and attention-deficit hyperactivity disorder (ADHD) in 29.1%, these being the most frequent PDs in this series. Focal epilepsy was significantly more frequent in children and adolescents with PDs. As to the type of PD, age was an important factor, with a predominance of ADHD in children and depression in adolescents (P < 0.0001). Family history was contributory for depression, but not for others PDs (P < 0.0001). Depression remained underdiagnosed and untreated for a longer period. Impact of early diagnosis and treatment remains unknown. (C) 2004 Elsevier Inc. All rights reserved.