女性癫痫患者焦虑、抑郁和失眠发病率及相关因素分析

摘要

Objective To investigate the incidence and correlation factors of depression, anxiety and insomnia in adult female patient with epilepsy(PWE).Methods The general date of 428 adult female PWE was collected. The patients were assessed with Hamilton depression scale, Hamilton anxiety scale, Pittsburgh sleep quality index. The correlation factors were analyzed by Logistic stepwise regression.Results The incidences of depression,anxiety and insomnia in adult female PWE were 38.7%, 21.4%, 28.6% retrospectively.Influence on the stability of conjugal relationship and committed relationship, anxiety about the seizure, influence on the fertility and breast-feeding,stigma,age of onset and seizure frequency had relationship with anxiety(all P<0.05).Influence on the stability of conjugal relationship and committed relationship, age of onset, epilepsy duration and seizure frequency had relationship with depression(all P<0.05).Occupation, personality, interpersonal relationship and estradiol level had relationship with insomnia(all P<0.05).Logistic regression analysis showed influence on the stability of conjugal relationship(OR=3.103,95%CI:1.097-4.686, P=0.008), influence on the stability of committed relationship(OR=2.164, 95%CI:0.873 -3.752, P=0.005)and seizure frequency(OR =1.704, 95%CI:0.680-2.586,P=0.015)were the independent influencing factors of anxiety.Influence on the stability of conjugal relationship(OR=3.245,95%CI:1.536-5.108,P=0.003),influence on the stability of committed relationship (OR=3.151,95%CI:2.135-5.018, P=0.006), epilepsy duration(OR=1.196,95%CI:0.828 -2.654, P=0.035)and seizure frequency(OR =1.661, 95%CI: 1.033 -4.326, P=0.014)were the independent influencing factors of depression.Personality(OR=2.543,95%CI:1.237-4.686,P=0.003)and interpersonal relationship(OR =1.816, 95%CI: 0.905 -3.593, P=0.017)were the independent influencing factors of insomnia.Conclusions There are higher incidences of anxiety, depression and insomnia in adult female PWE. Anxiety and depression are associated with family factors, fertility, breast feeding, stigma and seizures itself, and insomnia is associated with personality and interpersonal relationships.%目的 探讨女性癫痫患者焦虑、抑郁和失眠的发病率和相关因素.方法 收集428例成人女性癫痫患者的一般资料,并采用汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、匹兹堡睡眠质量指数量表(PSQI)进行测评,相关因素用逐步逻辑回归进行分析.结果 女性癫痫患者并发焦虑、抑郁和失眠的发病率分别是38.7%,21.4%和28.6%.患病影响夫妻关系、患病影响恋爱关系、担心发作、担心影响生育和哺乳、羞耻感、起病年龄和发作频率均与焦虑相关(均P<0.05).患病影响夫妻关系、患病影响恋爱关系、起病年龄、病程和发作频率均与抑郁相关(均P<0.05).职业、性格、人际关系和雌二醇水平均与失眠相关(均P<0.05).Logistic回归分析显示,患病影响夫妻关系(OR=3.103,95%CI:1.097~4.686,P=0.008)、患病影响恋爱关系(OR=2.164,95%CI:0.873 ~3.752,P=0.005)和发作频率(OR =1.704,95%CI:0.680 ~2.586,P=0.015)是影响焦虑的独立影响因素.患病影响夫妻关系(OR=3.245,95%CI:1.536~5.108,P=0.003)、患病影响恋爱关系(OR =3.151,95%CI:2.135 ~5.018,P=0.006)、病程(OR =1.196,95%CI:0.828~2.654,P=0.035)和发作频率(OR=1.661,95%CI:1.033~4.326,P=0.014)是影响抑郁的独立影响因素.性格(OR=2.543,95%CI:1.237~4.686,P=0.003)和人际关系(OR=1.816,95%CI:0.905~3.593, P=0.017)是影响失眠的独立影响因素.结论 成人女性癫痫患者焦虑、抑郁和失眠发病率较高.焦虑和抑郁与家庭因素、生育、哺乳、羞耻感及癫痫发作有关,失眠与性格和人际关系有关.