癫痫儿童情绪行为问题现状及影响因素分析

doi:10.11852/zgetbjzz2022-0853

摘要/Abstract

摘要： 目的了解癫痫儿童情绪行为问题现状及影响因素,为疾病干预提供临床指导。方法 2021年5月1日—11月1日选取安徽省儿童医院神经内科收治的192例癫痫患儿为研究对象,并按年龄和性别为匹配条件,选取合肥市4所中小学学生进行1∶1配对,采用一般资料问卷及长处与困难问卷(SDQ)(父母版)对384名儿童家长进行问卷调查。结果癫痫患儿和正常儿童困难总分的异常检出率分别为25.00%与0.52%;癫痫儿童在情绪症状(t=33.343)、品行问题(t=23.123)、多动(t=19.499)、同伴交往问题得分(t=15.700)及困难总分(t=22.420)高于正常儿童,亲社会行为得分低于正常儿童(t=14.402),差异均有统计学意义 (P＜0.001);多因素分析显示服药种类、服药依从性、发作频率、是否医保、家庭月收入、主要照顾者性别均是癫痫患儿情绪行为的影响因素(P<0.05)。结论癫痫儿童比正常儿童更易出现情绪行为问题,家庭成员及医务人员应予以重视,亟待采取干预措施。

关键词: 癫痫, 情绪与行为问题, 长处与困难问卷, 儿童

Abstract: Objective To understand the status quo and influencing factors of emotional and behavioral problems in epileptic children and normal children, in order to provide clinical guidance for disease intervention. Methods A total of 192 cases of epileptic children admitted to the Department of Neurology of Anhui Children′s Hospital were selected from May 1st, to November 1st, 2021. Meanwhile, Students from four primary and middle schools in Hefei were selected matched by age and gender with the ratio of 1∶1. The parents of 384 children were surveyed by general information questionnaire and Strengths and Difficulties Questionnaire (SDQ) (parent version). Results The abnormal detection rate of total difficulty in epileptic children and normal children was 25.00% and 0.52%, respectively. Children with epilepsy had significantly higher scores of emotional symptoms (t=33.343), conduct problems (t=23.123), hyperactivity problems (t=19.499), peer communication problems (t=15.700), total difficulty scores (t=22.420) and lower score of prosocial behavior (t=14.402) than normal children (P<0.001). Multivariate analysis showed that the type of medication, medication compliance, the frequency of attacks, the medical insurance, the monthly family income, and the gender of the main caregiver were the factors influencing the emotional behavior in children with epilepsy (P＜0.05). Conclusions Children with epilepsy are more likely to have emotional and behavioral problems than normal children. Family members and medical staff should pay attention to it and urgently take intervention measures.

Key words: epilepsy, emotional and behavioral problems, Strengths and Difficulties Questionnaire, children

中图分类号:

R742.1

余卫红, 潘月瑢, 年士翠, 余祖琳. 癫痫儿童情绪行为问题现状及影响因素分析[J]. 中国儿童保健杂志, 2023, 31(2): 210-214.

YU Wei-hong, PAN Yue-rong, NIAN Shi-cui, YU Zu-lin. Status quo and influencing factors of emotional behavior problems in children with epilepsy[J]. Chinese Journal of Child Health Care, 2023, 31(2): 210-214.

参考文献

[1] 牛国辉,谢加阳,朱登纳.脑性瘫痪患儿共患癫痫的危险因素[J].中国儿童保健杂志,30(11):1241-1245.
Niu GH, Xie JY, Zhu DN, et al.Risk factors for co-developing epilepsy in children with cerebral palsy[J].Chin J Child Health Care,30(11):1241-1245.
[2] Lhatoo SD,Bernasconi N,Blumcke I,et al.癫痫大数据:临床和研究考虑-来自国际抗癫痫联盟癫痫大数据工作组的报告[J].癫痫杂志,2021,7(2):173-182.
Lhatoo SD,ernasconi N,Blumcke I,et al.Epilepsy Big Data:Clinical and research considerations-report from the International Alliance for Epilepsy Big Data Working Group[J]. J Epilepsy, 2021,7 (2):173-182.
[3] 黄婷婷,姚宝珍,朱恒博,等.癫痫儿童行为问题及情绪障碍研究[J].武汉大学学报(医学版),2018,39(2):184-188.
Huang TT, Yao BZ, Zhu HB, et al. Study on behavioral problems and mood disorders in children with epilepsy[J].Med J Wuhan Univ, 2018,39 (2):184-188.
[4] 陈燕惠.关注癫痫儿童的心理行为问题[J].中国儿童保健杂志,2018,26(2):117-119.
Chen YH. Focus on psychobehavioral problems in children with epilepsy[J]. Chin J Child Health Care, 2018,26 (2):117-119.
[5] Aaberg KM, Bakken IJ.Comorbidity and childhood epilepsy:A nationwide registry study[J].Pediatrics,2016,138(3):e20160921.
[6] Malhi P,Annam A,Singhi P. Psychopathology and quality of life in children with epilepsy:A cross-sectional study[J]. Indian J Pediatr, 2021,88(7):712-714.
[7] Shafran R, Bennett S,Coughtrey A, et al.Optimising evidence-based psychological treatment for the mental health needs of children with epilepsy:Principles and Methods[J]. Clin Child Fam Psychol Rev,2020,23(2):284-295.
[8] 唐丽君,张海涛,陈蕾,等.韦氏儿童智力量表全式和简式在智力评残中的应用效果[J].中国当代医药,2022,29(6):66-68,72.
Tang LY, Zhang HT, Chen L, et al.Application effect of full and simple intelligence scale in intelligence evaluation[J].China Mod Med, 2022,29 (6):66-68,72.
[9] 王鹭,黄彦科,江文庆,等.深圳市南山区学龄前儿童心理卫生问题及其影响因素分析[J].中国儿童保健杂志,2019,27(5):527-530.
Wang L,Huang YK,Jiang WQ, et al. Analysis of psychological health problems and their influencing factors in Nanshan District, Shenzhen[J].Chin J Child Health Care, 2019,27 (5):527-530.
[10] Gao X, Shi W, Zhai Y, et al. Results of the parent-rated Strengths and Difficulties Questionnaire in 22,108 primary school students from 8 provinces of China[J].Shanghai Arch Psychiatry, 2013,25(6):364-74.
[11] 许文兵,王孟成,邓嘉欣,等.长处和困难问卷中文版的信度概化分析[J].中国临床心理学杂志,2019,27(1):67-72.
Xu WB, Wang MC, Deng JX, et al. Reliability generalization analysis of the Chinese version of the Strength and Difficulties Questionnaire[J]. Chin J Clin Psychol, 2019,27 (1):67-72.
[12] 黄韵如,晏强,李远艺,等.长沙市737名6～17岁中小学生长处和困难问卷调查分析[J].中南大学学报(医学版),2012,37(8):860-864.
Huang YR, Yan Q, Li YY, et al. Questionnaire survey and analysis of the strengths and difficulties of 737 primary and middle school students aged 6 to 17 years in Changsha city[J]. Med J Central South Univ, 2012,37 (8):860-864.
[13] George C, Felix SA, McLellan A, et al. Pilot project of psychological services integrated into a pediatric epilepsy clinic:Psychology Adding Value-Epilepsy Screening (PAVES)[J].Epilepsy Behav. 2021,120(7):107968.
[14] Rai D,Kerr MP,McManus S,et al.Epilepsy and psychiatric comorbidity:A nationally representative population-based study[J].Epilepsia,2012,53(6):1095-1103.
[15] Sucksdorff D,Brown AS, Chudal R, et al.Parental and comorbid epilepsy in persons with bipolar disorder[J]. J Affect Disord,2015,188(8):107-111.
[16] 花倩,周进芳,刘巧美.癫痫患儿心理行为特征与服药依从性的关系[J].安徽医学,2019,40(12):1396-1398.
Hua Q, Zhou JF, Liu QM. Relationship between psychobehavioral characteristics and medication adherence in children with epilepsy[J]. Anhui Med J, 2019,40 (12):1396-1398.
[17] 刘星宇.丙戊酸钠与左乙拉西坦对新诊断癫痫患儿认知功能影响的临床分析[D].重庆:重庆医科大学,2016.
Liu XY. Clinical analysis of the effects of sodium valproate and levetiracetam on cognitive function in children with newly diagnosed epilepsy[D]. Chongqing:Chongqing Medical University, 2016.
[18] Bektaş G, Tekin U, Özkan MU, et al. The influence of levetiracetam on psychosocial and behavioral functioning in children:A case-control and follow-up study[J].Epilepsy Behav,2017,72(4):39-42.
[19] Jense A,Douville A,Weiss A.The safety of rapid infusion levetiracetam:A systematic review[J]. Pharmacotherapy,2022,42(6):495-503.
[20] Herrmann J,Vogel M, Pietzner D, et al.Factors associated with the emotional health ofchildren:High family income as a protective factor[J].Eur Child Adolesc Psychiatry,2018,27(3):319-328.
[21] Peters I,Handley T,Oakley K, et al. Social determinants of psychological wellness for children and adolescents in rural NSW[J]. BMC Public Health, 2019,19(1):1616.
[22] 宝家怡,吴倩影,张蕾,等.上海市高危青少年心理健康状况及相关影响因素分析[J].精神医学杂志,2017,30(5):321-325.
Bao JY,Wu QY, Zhang L,et al. Analysis of mental health status and related influencing factors of high-risk adolescents in Shanghai[J]. J Psychiatry,2017,30 (5):321-325.