癫癎患者生活质量的研究

目的探讨成年癫癎患者生活质量状况及其影响因素.方法实验组86例癫癎患者,对照组59名健康自愿受试者.用世界卫生组织生存质量量表中文版简表(Q0 L-BREF)、癫癎患者生活质量量表(QOLIE-31)评定生活质量;用症状自评量表评价心境健康;分析各种影响因素的作用.结果实验组生活质量在心理领域得分比对照组低(P＜0.05);除精力/疲乏领域外的各领域均有50%以上实验组QOLIE-31得分低于平均水平;实验组的抑郁、焦虑分均比对照组明显增高(P＜0.0001);影响QOLIE总分的三个因素按作用大小依次是抑郁、焦虑和用药种数.结论癫癎患者生活质量下降,心境健康恶化;对总体QOLIE影响最大的因素是抑郁、焦虑和用药种数.     

藏族全面性强直阵挛性癫(癎)患者生活质量及其影响因素的调查

目的调查藏族地区全面性强直阵挛性癫癎患者生活质量及其影响因素。方法应用癫癎患者生活质量评定量表-31(QOLIE-31)对126例确诊为全面性强直阵挛性癫癎的藏族患者进行生活质量评定,并对影响其生活质量的因素进行分析。结果QOLIE-31总评分为(48.58±17.29)分,分项中对发作担忧评分最低[(32.92±22.97)分],药物影响的评分最高[(77.11±20.98)分]。单因素分析显示:不同性别、职业、婚姻状况、年龄、文化程度的生活质量评分差异有统计学意义(均P<0.05);而不同发作频率、治疗与否评分差异无统计学意义。多因素分析表明,年龄、起病年龄、职业、文化程度、经济状况、发作次数是影响藏族全面性强直阵挛性癫癎患者生活质量的因素(均P<0.05);其中年龄、职业影响生活质量多个方面,而病程、婚姻状况、性别不是影响因素。结论藏族全面性强直阵挛性癫癎患者的生活质量差;职业、经济状况、文化程度、年龄、起病年龄、发作频率是影响生活质量的因素;年龄、职业影响生活质量的多个方面。     

拉莫三嗪对癫癎患者生活质量影响的研究

目的:评价拉莫三嗪对癫癎患者生活质量的影响.方法: 采用多中心、前瞻性的研究方法,对新诊断癫癎患者应用拉莫三嗪治疗,并在基线期及用药6个月后,采用QOLIE-31、MOS SF-36量表、数字符号转换测验、HAMD抑郁量表和女性专用调查问卷对患者进行生活质量评价.结果: 共纳入新诊断癫癎患者282例.MOS SF-36量表的8个项目得分在用药后均有显著提高(P<0.01);QOLIE-31问卷中"对癫癎的担心","情绪"、"活力","认知","药物不良反应"、"社会功能"及"总体自身健康评价"项目得分在用药后均有显著提高(P<0.01).用药后,患者Hamilton抑郁量表平均3.65分,显著低干基线期6.42分(P<0.01);数字符号转换测验得分在用药后与基线期比较有显著提高(P<0.01).结论: 拉莫三嗪初始单药治疗能在一定程度上改善新诊断癫癎患者的生活质量.     

癫(癎)患者生活质量及其影响因素的研究

目的:研究癫癎患者生活质量特点及其影响因素.方法:采用病例-对照、问卷调查的方法进行评估分析.结果:成人与儿童癫癎患者生活质量显著下降(P<0.001),成人和儿童分别以社会功能(患者55.6±31.3,正常对照87.0±22.6)和社会支持(患者34.6±29.1,正常对照70.7±27.4)的损害最为严重.成人患者焦虑与抑郁的得分显著高于对照组(P<0.01).药物不良反应和社会心理学评分水平与生活质量多个方面独立相关.结论:癫癎患者生活质量受损,以社会功能/社会支持损害最为严重.社会心理学和药物不良反应比疾病本身对生活质量的影响更大.     

成年癫(癎)患者的抑郁情绪相关因素及生活质量研究

目的 调查成年癫(癎)患者抑郁的患病率及可能的危险因素;评价各种危险因素对癫(癎)伴发抑郁患者生活质量的影响.方法 采用Beck抑郁问卷(BDI)及癫(癎)患者生活质量量表-31(QO-LIE-31 中文版),并自制一般情况调查表对患者进行测查.用χ2检验、t检验及Logistic多元回归分析.结果 在120例成年癫(癎)患者中47.5%伴发抑郁.负性影响癫(癎)患者伴发抑郁的因素为发作频率,而正性影响因素根据影响程度的大小依次为职业和对癫(癎)相关知识的掌握情况.结论 癫(癎)患者抑郁发生率高且受多种因素的影响.积极控制癫(癎)发作、为癫(癎)患者提供更多的就业机会及对癫(癎)患者做好相关知识宣传、增加患者对癫(癎)相关知识的掌握程度是改善癫(癎)患者生活质量的重要因素.     

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.     

老年隐源性癫(癎)患者临床特点和生活质量的研究

目的 研究老年隐源性癫(癎)患者的临床特点和生活质量.方法 采用临床调查表、癫(癎)患者生活质量量表-31(QOLIE-31)、汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HAMA),对35例老年隐源性癫(癎)的患者(老年组)和70例青年患者(青年组)进行评定.结果 与青年组比较,老年组有发作诱因和服多种药的比率低,有共病的比率高(均P<0.05).QOLIE-31中在发作担忧和药物影响两个子项目的 评价上优于青年组,但老年组总体生活质量与青年组的差异无统计学意义.单因素分析显示性别、发作类型、药物不良反应、发作后不适感、抑郁和焦虑是影响老年组生活质量的因素;多元逐步回归分析显示,对老年组生活质量评分起主要作用的是焦虑和发作后不适感(均P<0.01).结论 老年隐源性癫(癎)患者具有发作诱因少、共病多和服单种抗癫(癎)药物为主的临床特点.老年患者和青年患者的总体生活质量水平相近.焦虑和发作后不适感是影响老年患者生活质量的重要因素.     

高癎龄癫癎患者智力及生活质量的研究

目的　探讨高癎龄癫癎患者的智力及生活质量。方法　对 12 5例高癎龄癫癎患者进行研究。结果　高癎龄癫癎患者智力不受影响 ,生活质量低于正常人。结论　高癎龄癫癎在给予抗癫癎药物治疗的同时 ,应配合心理治疗 ,以提高其生活质量     

成人癫痫患者生活质量评定研究进展

癫痫（EP）是一种常见的慢性神经系统疾病,EP的反复发作、长期服用抗癫痫药物（AEDs）、社会歧视等使患者的生活质量显著下降,成人EP患者生活质量受躯体、社会、心理等多方面因素的影响。有效控制患者的EP发作,尽量采用单药治疗、个体化用药及应用新型AEDs等,并提高EP患者的社会支持,从而提高EP患者的生活质量。     

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.     

左乙拉西坦添加治疗对难治性部分性癫(癎)患者生活质量影响的研究

目的:评价新型抗癫药物左乙拉西坦(Lev)作为添加治疗对难治性部分性癫患者生活质量的影响。方法:43例确诊有癫部分性发作的成年患者随机分为两组:Lev治疗组与安慰剂组,Lev治疗16周后比较两组的有效率和不良反应,并用QOLIE-31量表对两组癫患者进行生活质量评定,所有患者在转入Lev开放性治疗6个月后再次进行QOLIE评估。结果:16周治疗期末Lev组癫部分性发作的治疗有效率明显高于安慰剂组,两组不良反应的发生率相当;Lev组生活质量明显高于安慰剂组,两组患者转入开放性治疗6个月后,生活质量均显著改善。结论:Lev作为添加用药治疗成人难治性部分性癫发作,显著减少发作频率、安全耐受性较好,能够提高癫患者的生活质量。     

拉莫三嗪对癫痫患者生活质量影响的研究

目的：评价拉莫三嗪对癫痫患者生活质量的影响。方法：采用多中心、前瞻性的研究方法,对新诊断癫痫患者应用拉莫三嗪治疗,并在基线期及用药6个月后,采用QOLIE-31、MOSSF-36量表、数字符号转换测验、HAMD抑郁量表和女性专用调查问卷对患者进行生活质量评价。结果：共纳入新诊断癫痂患者282例。MOSSF-36量表的8个项目得分在用药后均有显著提高（P〈0．01）;QOLIE-31问卷中“对癫痫的担心”、“情绪”、“活力”、“认知”、“药物不良反应”、“社会功能”及“总体自身健康评价”项目得分在用药后均有显著提高（P〈0．01）。用药后,患者Hamilton抑郁量表平均3．65分,显著低于基线期6．42分（P〈0．01）;数字符号转换测验得分在用药后与基线期比较有显著提高（P〈0．01）。结论：拉莫三嗪初始单药治疗能在一定程度上改善新诊断癫痫患者的生活质量。     

育龄期女性癫痫患者社会心理及生活质量的研究

目的：研究女性癫痫患者社会心理及生活质量损害的特点及其影响因素。方法：对161例18-50岁女性（女性癫痫患者81例及健康女性80例）进行一般生活情况,疾病史及妇产科病史的调查。应用抗癫痫药物的不良反应量表,癫痫患者的生活质量-31项量表,焦虑自评量表,汉密尔顿抑郁量表,亚利桑那州女性性体验量表,进行社会心理和生活质量评定,比较其在癫痫患者与正常女性之间的差异并探索相关的影响因素。结果：女性癫痫患者存在广泛的社会心理及生活质量损害。女性患者在抑郁发生和性功能障碍与健康女性有明显差异。抑郁、性功能障碍、癫痫发作频率、抗癫痫药物的不良反应、个人收入、用药依从性是影响女性癫痂患者生活质量的重要因素。结论：育龄期女性癫痫患者需要更多的治疗和心理方面的关心指导,以利于提高其生活质量。     

Assessment of Quality of Life in People with Epilepsy: Some Practical Implications

Summary: Growing recognition of the need to assess the impact of epilepsy on psychosocial functioning has led to a number of initiatives to quantify quality of life (QOL) in patients with this condition. To understand the impact of epilepsy and its treatment, physical, social, neuropsychological, and psychological functioning aspects must be considered. It also is apparent from previous research work that measures of QOL should be comprehensive enough to address the question under consideration, but also simple and as brief as possible. A number of QOL measures for assessing the impact of epilepsy and its treatment exist, such as the Washington Psychosocial Seizure Inventory, the Social Effects Scale, the Epilepsy Surgery Inventory, the Quality of Life in Epilepsy (QOLIE) questionnaire, and the Liverpool QOL Battery. These measures have in most cases been shown to be reliable, valid, and sensitive to change, although at the current stage of development, some are better validated than others. It is generally agreed that the best approach is to use a standard generic instrument with disease-specific additions. Selection of a measure already in existence is recommended, as the process of producing a new measure is costly in terms of both resources and time. Some consideration also needs to be given to factors such as the process of administration (e.g., self-completion or administration at interview) or the timing of data collection. Then questions such as the cross-cultural applicability of QOL measures and the real relevance of the changes remain to be answered. It is hoped that, over the next few years, significant progress will be made in addressing these issues.     

血药浓度监测对成人癫痫患者生活质量的影响

目的 观察血药浓度监测对成人癫痫患生活质量的影响。方法 用前瞻性、自身对照的方法对长期服用抗癫痫药治疗效果不佳的成人癫痫患进行了血药浓度和生活质量的评定，观察其药物影响的特点。结果 (1)患组与对照组相比生活质量方面差别具有非常显性意义(P＜0．01)；(2)有效治疗浓度范围内急生活质量提高，差别有显性意义(P＜0．05)；(3)血药浓度与生活质量间具有显正相关(P＜0．01)。结论 成人癫痫患存在生活质量下降，合理用药、血药浓度监测可控制癫痫发作、提高患生活质量。     

Psychiatric Symptoms and Quality of Life in Patients with Drug-Refractory Epilepsy Receiving Adjunctive Levetiracetam Therapy

Background and Purpose

Levetiracetam (LEV) is a new antiepileptic drug that has been found to be effective as an adjunctive therapy for uncontrolled partial seizures. However, the results of several studies suggested that LEV has negative psychotropic effects, including irritability, aggressiveness, suicidality, and mood disorders. We investigated the impact of adjunctive LEV on psychiatric symptoms and quality of life (QOL) in patients with drug-refractory epilepsy (DRE) and determined the risk factors provoking psychiatric adverse events.

Methods

A 24-week, prospective, open-label study was conducted. At enrollment, we interviewed patients and reviewed their medical charts to collect demographic and clinical information. They were asked to complete self-report health questionnaires designed to measure various psychiatric symptoms and QOL at enrollment and 24 weeks later.

Results

Seventy-one patients were included in the study, 12 patients (16.9%) of whom discontinued LEV therapy due to serious adverse events including suicidality. The risk factor for premature withdrawal was a previous history of psychiatric diseases (odds ratio 4.59; 95% confidence interval, 1.22-17.32). LEV intake resulted in significant improvements in Beck Anxiety Inventory score (p<0.01) and some domains of the Symptom Checklist-90-Revised, such as somatization (p<0.05), obsessive-compulsiveness (p<0.05), depression (p<0.05), and anxiety (p<0.05). These improvements were not related to the occurrence of seizure freedom. The Quality of Life in Epilepsy Inventory-31 overall score and subscale scores, such as seizure worry (p<0.01), overall QOL (p<0.05), emotional well-being (p<0.05), energy-fatigue (p<0.05), and social function (p<0.05), also improved.

Conclusions

Adjunctive LEV in patients with DRE is likely to improve psychiatric symptoms and QOL. Clinicians should be well aware of the psychiatric histories of patients to prevent them from developing serious adverse events related to LEV.     

Adolescent and Maternal Perspectives of Quality of Life and Neuropsychological Status Following Epilepsy Surgery

A convenience sample of 13 adolescents who had undergone epilepsy surgery and their mothers reported their perceptions of change in areas affecting quality of life (physical, affect/behavior, social, cognition/academics, and family). A mixed method approach was used, with self-report and maternal-report narratives (qualitative measures), as well as neuropsychological profiles (quantitative measures). The results demonstrate that change after epilepsy surgery is multifaceted, and that adolescent and maternal perceptions are notably different. Whereas most adolescents experienced positive changes, mothers simultaneously reported many more negative changes along with positive changes. Furthermore, mothers frequently described aspects of their adolescent's life that continued to be of concern, whereas adolescents did not. The findings strongly suggest that the processes involved in postsurgical adjustment are complex. The development of a theoretical model is essential to help build an understanding of factors that contribute to positive and negative outcomes.     

Effect of Long-Term Treatment with Vagus Nerve Stimulation on Mood and Quality of Life in Korean Patients with Drug-Resistant Epilepsy

Background and PurposeThis study aimed to determine the long-term effects of vagus nerve stimulation (VNS) treatment on suicidality, mood-related symptoms, and quality of life (QOL) in patients with drug-resistant epilepsy (DRE). We also investigated the relationships among these main effects, clinical characteristics, and VNS parameters.MethodsAmong 35 epilepsy patients who underwent VNS implantation consecutively in our epilepsy center, 25 patients were recruited to this study for assessing the effects of VNS on suicidality, mood-related symptoms, and QOL. The differences in these variables between before and after VNS treatment were analyzed statistically using paired t-tests. Multiple linear regression analyses were also performed to determine how the patients'' demographic and clinical characteristics influenced the variables that showed statistically significant changes after long-term VNS treatment.ResultsAfter VNS, our patients showed significant improvements not only in the mean seizure frequency but also in suicidality, depression, and QOL. The reduction in depression was associated with the improvement in QOL and more-severe depression at baseline. The reduction in suicidality was associated with higher suicidality at baseline, smaller changes in depression, and less-severe depression at baseline. Improved QOL was associated with lower suicidality at baseline.ConclusionsThis study found that VNS decreased the mean seizure frequency in patients with DRE, and also improved their depression, suicidality, and QOL. These results provide further evidence for therapeutic effect of VNS on psychological comorbidities of patients with DRE.