Factors Associated With Anxiety/Depression In Adolescents With Epilepsy And Systemic Family Therapy

Part OneFACTORS ASSOCIATED WITH ANXIETY/DEPRESSION IN ADOLESCENTS WITH EPILEPSYObjective:To investigate the prevalence of anxiety/depression and thefactors associated with anxiety/depression in adolescents with epilepsy.Methods：275participants with epilepsy were obtained demographicand clinical information.They and170normal adolescents matched bygender and age were evaluated by Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD), Social Support Rating Scale (SSRS),Family Assessment Device (FAD), Self Rating Scale of Systemic FamilyDynamics (SSFD). Statistical analysis included Chi square test, t-test,analysis of variance(ANOVA), pearson correlation analysis,multiple linearregression analysis.Results：(1)In our study260adolescents with epilepsy out of140suffered from anxiety/depression (53.85%);89of them had anxiety (34.23%)and108of them had depression(41.54%), which was significantly differentfrom the control group(p<0.01).(2) the seizure frequency, course of disease and number of medication, the type seizure, the onset form were correlatedwith ADAE and the seizure frequency was the risk factors for anxiety whilecombined therapy of AEDs was the risk factors for depression.(3)FamilyDynamics, family function and social support of normal adolescents werebetter than ADAE and adolescents with epilepsy. Family atmosphere andindividuation in SSFD, behavior control in FAD were the risk factors forADAE while the total scores of social support in SSRS was protective factorADAE.Conclusion：(1) Both depression and anxiety in adolescents withepilepsy are common.(2) The etiology or the risk factors for anxiety anddepression in adolescents with epilepsy are likely multifactorial involvingneurobiological, AEDs and psychosocial factors.(3) Seizure frequency,combined therapy of AEDs, family atmosphere, individuation and controlwere the risk factors while the social support was protective factor for anxiety/depression of adolescents with epilepsy Part TwoSYSTEMIC FAMILY THERAPY FORANXIETY/DEPRESSIONIN ADOLESCENTS WITHEPILEPSYObjective: To evaluate the efficacy of systemic family therapy （SFT）for anxiety/depression in adolescents with epilepsy.Methods：104participants evaluated in the part one were divided intotwo groups: intervention group (n=58) and control group (n=46). controlgroup only received the treatment of antiepileptic drugs（AEDs），whereasintervention group received the treatment of AEDs combined with SFT.Statistical analysis included Chi square test, t-test, pearson correlationanalysis,multiple linear regression analysis.Results:(1) the seizure frequencies for two groups after treatment weresignificantly lower than before(P<0.05), whereas intervention group wassignificantly different from the control group(p<0.05);(2) intervention groupshowed HAMA and HAMD scores were lower than pretherapy and controlgroup, with obvious statistical significance(p<0.05);(3) intervention groupshowed family dynamic, family function and social support were better thanpretherapy and control group, with obvious statistical significance (p<0.05);（4）the variation of seizure frequency, family atmosphere and anxiety hadgreat influence on depression while the variation of subjective support, behavior control，family atmosphere and depression had great influence onanxiety；the variation of depression had great influence on seizure frequency.Conclusion：(1) the treatment of AEDs combined with SFT is betterthan AEDs, which not only reduces seizure frequencies but also relieveanxiety and depression, make family dynamic, family function and socialsupport better.(2) SFT may be practical and effective methods to interveneADAE.