癫(疒间)患者焦虑抑郁情绪研究

目的:探讨癫(疒间)患者焦虑抑郁情绪的有关因素. 方法:80例成年癫疒间患者,前期诊疗不规范,采用焦虑自评量表(SAS)和抑郁自评量表(SDS)评估. 结果:癫疒间合并焦虑情绪者25%,合并抑郁情绪者45%.多因素回归分析结果显示,病程越长,发作程度越严重,男性患者更易产生焦虑情绪,而居住在农村的癫疒间患者更易产生抑郁情绪. 结论:癫疒间患者焦虑抑郁情绪明显高于正常人群,性别、病程、发作严重程度和生活居住地是影响癫疒间患者焦虑抑郁情绪的独立危险因素.     

心理干预对癫患者焦虑抑郁情绪的影响

目的:探讨心理干预对癫患者焦虑抑郁情绪的影响。方法:对163例成人癫患者在抗癫治疗的同时实施为期3个月的心理干预;采用中文版Zung焦虑自评量表(SAS)及抑郁自评量表(SDS)分别于干预前、干预后1个月和3个月进行评定。结果:163例癫患者实施心理干预后焦虑和抑郁情绪改善显著,并随干预时间延长而显著下降。与干预前比较,干预1周,SAS及SDS评分与干预前差异无统计学意义(P=0.469、0.272);干预1个月和3个月,SAS及SDS评分与干预前比较差异有显著统计学意义(F=15.196、16.207,P均<0.001)。结论:癫患者焦虑抑郁情绪明显;心理干预能够显著改善患者焦虑抑郁情绪;干预时间越长,效果越好。     

焦虑、抑郁情绪对癫患者生活质量的影响

目的 探讨焦虑、抑郁情绪对癫(癎)患者生活质量的关系.方法 应用生活质量综合评定问卷(GQOLI)、Zung焦虑自评量表 (SAS)及Zung抑郁自评量表 (SDS)对60例癫(癎)患者(癫(癎)组)及60名健康自愿者(对照组)进行评定,并对生活质量与焦虑、抑郁作相关分析.结果 癫(癎)患者的生活质量总分及躯体功能、心理功能、社会功能、物质生活4个维度分均明显低于对照组(P＜0.01),而SAS及SDS评分则均明显高于对照组(P＜0.01);生活质量总分及躯体功能、心理功能、社会功能、物质生活4个维度分均与SAS及SDS评分呈显著性负相关.结论 癫(癎)患者的生活质量较差,焦虑、抑郁情绪明显;其生活质量与焦虑、抑郁情绪密切相关.     

焦虑、抑郁情绪对癫患者生活质量的影响

目的探讨焦虑、抑郁情绪对癫患者生活质量的关系。方法应用生活质量综合评定问卷(GQOLI)、Zung焦虑自评量表(SAS)及Zung抑郁自评量表(SDS)对60例癫患者(癫组)及60名健康自愿者(对照组)进行评定,并对生活质量与焦虑、抑郁作相关分析。结果癫患者的生活质量总分及躯体功能、心理功能、社会功能、物质生活4个维度分均明显低于对照组(P<0.01),而SAS及SDS评分则均明显高于对照组(P<0.01);生活质量总分及躯体功能、心理功能、社会功能、物质生活4个维度分均与SAS及SDS评分呈显著性负相关。结论癫患者的生活质量较差,焦虑、抑郁情绪明显;其生活质量与焦虑、抑郁情绪密切相关。     

成年癫癎患者合并抑郁障碍的临床研究

目的研究成年癫癎患者合并抑郁障碍的主要影响因素。方法应用24项汉密尔顿抑郁量表进行测评,并对癫癎合并抑郁障碍的相关危险因素进行分析。结果癫患者抑郁障碍发生率显著高于对照组。就业状况、病程、使用抗癫癎药物治疗方式、难治性癫、合并其他疾病为癫患者合并抑郁障碍的相关危险因素。结论癫癎合并抑郁障碍的发病率高。早期诊断及治疗癫合并抑郁障碍对提高患者临床疗效及生活质量有重要意义。     

焦虑、抑郁情绪对癫(癎)患者生活质量的影响

目的 探讨焦虑、抑郁情绪对癫(癎)患者生活质量的关系.方法 应用生活质量综合评定问卷(GQOLI)、Zung焦虑自评量表 (SAS)及Zung抑郁自评量表 (SDS)对60例癫(癎)患者(癫(癎)组)及60名健康自愿者(对照组)进行评定,并对生活质量与焦虑、抑郁作相关分析.结果 癫(癎)患者的生活质量总分及躯体功能、心理功能、社会功能、物质生活4个维度分均明显低于对照组(P＜0.01),而SAS及SDS评分则均明显高于对照组(P＜0.01);生活质量总分及躯体功能、心理功能、社会功能、物质生活4个维度分均与SAS及SDS评分呈显著性负相关.结论 癫(癎)患者的生活质量较差,焦虑、抑郁情绪明显;其生活质量与焦虑、抑郁情绪密切相关.     

抑郁、焦虑对癫(癎)患者健康相关生存质量的影响

目的 调查癫(癎)患者健康相关生存质量和情绪健康状况,探讨各种因素对患者生存质量的影响.方法 使用世界卫生组织(WHO)生存质量量表中文版简表(QOL-BREF)附加癫(癎)生存质量量表(QOLIE)-31(中文版)、抑郁自评量表(SD5)、焦虑自评量表(SAS)进行生存质量和心境健康状况调查.多元逐步回归分析各种因素对生存质量的影响.结果 癫(癎)患者(n=141)在WHOQOL-BREF的生理、心理领域得分(分别为12.7±1.8、12.4 4-1.9)比常模下降(15.1±2.3、13.9±1.9,t=11.75、8.625,P<0.05);有抑郁情绪者占57.4 % ,有焦虑情绪者占39.7 % .合并抑郁、焦虑情绪的癫(癎)患者在除外QOLIE-31药物的影响领域的生存质量各个领域得分均减低;多元逐步回归结果显示,影响QOLIE总分的3个因素按影响作用大小依次是焦虑、抑郁和病程.结论 合并抑郁、焦虑情绪障碍,病程长是癫(癎)患者生存质量下降的重要因素.     

癫合并焦虑

近年来人们日益认识到癫(Ep)合并情感性精神障碍的重要性,但多数研究集中干抑郁症。然而,Ep伴发焦虑障碍十分普遍,文献报道焦虑障碍的患病率达111%~46%。有研究表明,Ep和焦虑具有双向联系,且可能有共同的病理生理基础。焦虑严重影响Ep患者的生活质量,放大抗癫药物的不良反应。尽管如此,临床上常忽略对焦虑症状的筛查。Ep患者的焦虑症状可分为仅出现于Ep发作前、中和后(围Ep发作期)的焦虑,类似原发性焦虑障碍的焦虑症,或与Ep本身或其治疗有关的焦虑。对Ep焦虑症状的治疗包括:更有效的控制Ep发作治疗围Ep发作期的焦虑,而大多数形式的焦虑发作以认知行为治疗或药物治疗为主。     

抑郁、焦虑对癫(癎)患者健康相关生存质量的影响

Objective To assess health-related quality of life and the mood disorder in adults with epilepsy,and to evaluate factors contributing to the quality of life.Methods Quality of life was measured by the Quality of Life in Epilepsy Inventory(QOLIE-31)and the World Health Organization Quality of Life Assessment-Bref(WHOQOL-BREF).Psychotic conditions were evaluated by Self-rating Depressive Scale (SDS)and Self-rating Anxious Seale(SAS).The multivariate analysis was used to assess the determinant factors.Results The study included 141 epilepsy patients in the teat group and 59 sex,age,and education matched normal controls. WHOQOL-BREF scores in the physical and psychological aspects were significantly lower in epilepsy patients(12.7 ±1.8 and 12.4±1.9,respectively)than those in the normal controls(15.1 ±2.3 and 13.9 ±1.9,respectively,t value were 11.75 and 8.625.both P<0.05).The survey reported that 57.4 % of the epilepsy patients suffered with depression.and 39.7 % anxiety.The patients with both anxiety and depression scored lower in all aspects in QOLIE survey except medical effect.Multivariate analysis showed that factors that effect the overall quality of life in order were anxiety.depression and disease duration.Conclusion Our results support that complications of anxiety and depression and long disease duration are key factors affecting the quality of life in epilepsy patients.     

抑郁、焦虑对癫(癎)患者健康相关生存质量的影响

Objective To assess health-related quality of life and the mood disorder in adults with epilepsy,and to evaluate factors contributing to the quality of life.Methods Quality of life was measured by the Quality of Life in Epilepsy Inventory(QOLIE-31)and the World Health Organization Quality of Life Assessment-Bref(WHOQOL-BREF).Psychotic conditions were evaluated by Self-rating Depressive Scale (SDS)and Self-rating Anxious Seale(SAS).The multivariate analysis was used to assess the determinant factors.Results The study included 141 epilepsy patients in the teat group and 59 sex,age,and education matched normal controls. WHOQOL-BREF scores in the physical and psychological aspects were significantly lower in epilepsy patients(12.7 ±1.8 and 12.4±1.9,respectively)than those in the normal controls(15.1 ±2.3 and 13.9 ±1.9,respectively,t value were 11.75 and 8.625.both P<0.05).The survey reported that 57.4 % of the epilepsy patients suffered with depression.and 39.7 % anxiety.The patients with both anxiety and depression scored lower in all aspects in QOLIE survey except medical effect.Multivariate analysis showed that factors that effect the overall quality of life in order were anxiety.depression and disease duration.Conclusion Our results support that complications of anxiety and depression and long disease duration are key factors affecting the quality of life in epilepsy patients.     

Clinical presentation of anxiety among patients with epilepsy

Different factors have been related with interictal anxiety, reported in 10%–25% of patients with epilepsy. We determined the frequency of interictal anxiety in 196 patients with active epilepsy in a cross-sectional survey to know which symptoms of anxiety were most frequently reported in patients with epilepsy and to analyze the factors associated with their presence. Patients were assessed with the Beck Depression Inventory (BDI), Montgomery-Asberg Depression Rating Scale (MADRS), and the Hamilton Anxiety Scale (HAMA). Data were analyzed with a logistic regression model. The HAMA ratings revealed that 38.8% experienced significant anxiety symptoms, as defined by a rating above 18 points. Use of primidone, depression, cryptogenic, and posttraumatic etiologies significantly predicted anxiety after logistic regression. Symptoms related to higher scores on HAMA were anxious mood, tension, insomnia, intellectual function, depressed mood, cardiovascular and genitourinary symptoms. Further studies should be performed to define the role of psychosocial factors in the development and evolution of anxiety among these patients.     

成年癫痫患者抑郁、焦虑状况及生活质量调查

目的调查成年癫痫患者抑郁、焦虑的患病率及可能的危险因素;评价抑郁及焦虑对癫痫患者生活质量的影响。方法采用Beck抑郁问卷(BDI)、贝克焦虑量表(BAI)及癫痫患者生活质量量表-31(QO-LIE-31中文版),对200例成年癫痫患者的抑郁、焦虑情况及生活质量进行评估。结果在200例癫痫患者中43.5%伴发抑郁,28.5%伴发焦虑,23%伴发抑郁及焦虑。发作频繁、无有薪职业是癫痫患者伴发抑郁的重要危险因素,无有薪职业是癫痫患者伴发焦虑的危险因素。抑郁组及抑郁伴焦虑组的QOLIE-31总分及各项评分均低于非抑郁非焦虑组(P=0.000);焦虑组的QOLIE-31总分(P=0.004)及发作的担忧(P=0.019)、认知功能(P=0.009)方面的得分均低于非抑郁非焦虑组。结论抑郁和焦虑是癫痫患者常见的精神共病,严重影响了癫痫患者的生活质量。积极控制发作、为癫痫患者提供更多的就业机会是改善癫痫患者生活质量的重要因素。     

Depression,anxiety and quality of life in parents of children with epilepsy

0bjectives – To assess the impact of childhood epilepsy on parental quality of life (QOL) and psychological health, and to investigate possible correlations between parental QOL and background variables as well as parental anxiety and depression. Subjects and methods – Parents having an epileptic child (n = 263) and parents having a healthy child (n = 270) were enrolled. Groups were in balance for background variables. Short‐Form Health Survey (SF‐36) Questionnaire, Zung Depression Scale (ZDS) and Zung Anxiety Scale (ZAS) were applied to all parents. Patients were divided into the first visit group (newly diagnosed epilepsy) and follow‐up visit group. Results – The parents of children with epilepsy had significantly lower QOL scores in SF‐36 for all subscales and higher levels of depression and anxiety by using ZDS and ZAS. The factors correlated with parental QOL were seizure control, visit status, anxiety, depression, employment, cost of epilepsy, status epilepticus, drug side effect and age of parents. Conclusions – Childhood epilepsy has a severe impact on parental QOL and psychological health, and recognition of possible correlations between parental QOL and background variables will be helpful to improve parental QOL.     

The nosologic relationship between generalized anxiety disorder and major depression

Generalized anxiety disorder (GAD) has undergone a series of revisions in its diagnostic criteria that has moved it, nosologically, away from its original affiliation with panic disorder (PD) and closer to major depressive disorder (MDD). This, together with its high comorbidity and putative shared genetic risk with MDD, has brought into question its place in future psychiatric nosology, prompting the planners of Diagnostic and Statistical Manual-V (DSM-V) and International Classification of Diseases-11 (ICD-11) to set up a workgroup tasked to better understand the relationship between GAD and MDD. This review attempts to summarize the extant data to compare GAD and MDD on a series of research validators to explore this relationship. Although insufficient data currently exist for GAD in several key validator classes, tentative conclusions can be drawn on the diagnostic status of GAD in relation to MDD. Although GAD possesses substantial overlap with MDD in the areas of genetics, childhood environment, demographics, and personality traits, this tends to hold true for other anxiety disorders (ADs) as well, with the strongest evidence for PD. Data from life events, personality disorders, biology, comorbidity, and pharmacology are mixed, showing some areas of similarity between GAD and MDD but some clear differences, again with a moderate degree of nonspecificity. Thus, although the bulk of evidence supports a close underlying relationship between them, the relatively nonspecific nature of these findings provides little more reason to question the nosologic validity of GAD in relation to MDD than that of some other anxiety disorders.     

Meta-analysis on anxiety and depression in adult celiac disease

Smith DF, Gerdes LU. Meta‐analysis on anxiety and depression in adult celiac disease. Objective: We used meta‐analysis to test hypotheses concerning whether adult celiac disease is reliably linked with anxiety and/or depression. Method: We examined published reports on anxiety and depression in adult celiac disease. Results: Eighteen studies on depression and eleven studies on anxiety in adult celiac disease met selection criteria. They show that depression is reliably more common and/or more severe in adults with celiac disease than in healthy adults (overall meta‐analysis effect size: 0.97). The fail‐safe margin of unpublished reports that would be required to negate the finding exceeds 8000. Adults with celiac disease do not, however, differ reliably in terms of depression from adults with other physical illnesses, nor do they differ reliably from healthy adults or adults with other physical illnesses in terms of anxiety. Conclusion: Depression is common in adult celiac disease and resembles the condition in other physical illnesses. We view the findings as support for the notion that non‐specific mechanisms mediate emotional disorders in adult celiac disease.     

Examination of the decline in symptoms of anxiety and depression in generalized anxiety disorder: impact of anxiety sensitivity on response to pharmacotherapy

Pharmacotherapy is an effective treatment for generalized anxiety disorder (GAD), but few studies have examined the nature of decline of anxiety and depression during pharmacotherapy for GAD and even fewer studies have examined predictors of symptom decline. This study examined the decline in symptoms of anxiety and depression in patients with GAD during a 6-week open trial of fluoxetine. Growth curve analyses indicated that pharmacotherapy with fluoxetine led to significant declines in symptoms of anxiety and depression over the 6 weeks of treatment. However, the decay slope observed for anxiety symptoms was significantly greater than that for depressive symptoms. Further analyses revealed that the decline in anxiety remained significant after accounting for the changes in symptoms of depression. However, the effect of treatment on depression was no longer significant after controlling for the reduction in anxiety symptoms. Overall anxiety sensitivity (AS) did not moderate the level of reduction in symptoms of anxiety or depression during pharmacotherapy. However, AS specific to physical concerns demonstated a marginal negative association with decline in anxiety and depression. AS specific to social concerns also demonstrated a marginal negative association with decline in anxiety symptoms. These findings suggest that the decline in anxiety symptoms is independent of the decline in symptoms of depression during pharmacotherapy for GAD and specific AS dimensions may predict symptom change in GAD.     

抑郁与焦虑共病障碍临床研究

目的:调查抑郁与焦虑共病障碍的发生率,探讨其特点及预后.方法:对150例抑郁障碍患者用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、社会功能缺陷筛选量表(SDSS)和临床疗效总评量表(CGI)评定,3个月后进行随访.结果:45.3%的抑郁障碍患者共病焦虑障碍,共病以广泛焦虑障碍与惊恐障碍为最多(分别为22.0%、13.3%);入组时及3个月末,共病组HAMD、HAMA、CGI及SDSS总分均显著高于抑郁组(P＜0.05),3个月末共病组HAMA减分率显著低于抑郁组(P＜0.05),HAMD减分率两组差异无显著性.结论:抑郁与焦虑共病障碍发生率高,具有抑郁及焦虑症状重、社会功能损害重,焦虑症状不易缓解等特征.