| Objective To analyze the prevalence and clinical features of depression,anxiety,sleep disorders and migraine in Tibet Tibetan patients with epilepsy,aiming to improve the level of depression,anxiety,sleep disorders and migraine diagnosis and treatment of epilepsy in this area.Methods 1.Collection of research data:Under the premise of medical ethics approval and informed consent of the subjects,according to the specified relevant standards（inclusion criteria and exclusion criteria）,the Department of Neurology of the People’s Hospital of Tibet Autonomous Region from 2017 to 2018 was selected.204 patients with epilepsy.2.Evaluation criteria:Depression,anxiety according to CCMD-3 criteria for the diagnosis of depression and anxiety,using Hamilton depression scale（HAMD 24）and Hamilton anxiety scale（HAMA 14）;the diagnosis of sleep disorders according to ICD-10,using the Pittsburgh Sleep Quality Index（PSQI）was measured;migraine was diagnosed according to Neurology[1],and the symptoms of depression,anxiety,sleep disorders,and migraine were analyzed in patients with epilepsy of different genders,ages,durations,frequency of seizure,and seizures types.3.Statistical analysis:Statistical analysis was performed using SPSS 23.0 statistical software.The measurement data is represented by?X±S,the normal distribution is measured by t test,and the non-normal distribution is measured by Z test.The count data is expressed by percentage.First,the?2 test is used to perform univariate analysis on the count data,and the single factor significant index continues.Logistic regression analysis was performed with a statistical significance of P value≤0.05.Results 1.Among the 204 patients with epilepsy,190（93.14%）had comorbidities,only 23（11.27%）comorbid depression,only 13（6.37%）comorbid anxiety,and only 15（7.35%）cases comorbid sleep disorders,only2（0.98%）cases comorbid migraines,137（67.16%）cases with 2 or more diseases,and 14（6.86%）cases without comorbidities.2.Univariate analysis showed that there was a statistically significant difference in the duration and frequency of epileptic seizures between depression and anxiety（P<0.05）.There was a statistically significant difference in the duration between sleep disorders（P<0.05）.there was a statistically significant difference in the age and frequency of seizures between migraine（P<0.05）.3.Multivariate logistic regression analysis showed that the probability of depression in epilepsy patients with seizure frequency<2 times/month was 1.9%of the frequency of seizures≥2 times/month[OR=0.019,95%CI（0.005,0.064）,P<0.05];The probability of anxiety in patients with a disease duration of≤2years is 23.2%of those with a course≥2 years[OR=0.232,95%CI（0.125,0.430）,P<0.05],seizure frequency<2 times/month The possibility of comorbid anxiety in patients with epilepsy is 38.8%of the frequency of seizures≥2 times/month[OR=0.388,95%CI（0.211,0.713）,P<0.05];patients with epilepsy with a course of<2 years suffer from sleep disorders is 2.373 times the disease course≥2 years[OR=2.373,95%CI（1.319,4.269）,P<0.05];the possibility of migraine in patients with epilepsy age<45 years is 38.1%age≥46 years[OR=0.381,95%CI（0.179,0.808）,P<0.05];the probability of migraine in patients with epileptic seizures<2 times/month is 20.5%of the frequency of seizures≥2 times/month[OR=0.205,95%CI（0.105,0.403）,P<0.05].Conclusions 1.Tibetan Tibetan patients with epilepsy have a high prevalence of depression,anxiety,sleep disorders and migraine,especially in combination with more than two diseases.Clinicians should strengthen their understanding in the diagnosis and treatment of epilepsy and give appropriate prevention and treatment.Improve the level of diagnosis and treatment.2.For patients with long course of disease and high frequency of seizures,screening for epilepsy and depression should be strengthened.3.For patients with relatively short course of disease,screening for sleep disorders should be strengthened.4.Strengthen the screening of migraine for patients≥46years old and frequent seizures. |
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