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目的探讨癫痫患者共情能力的损害及其与焦虑抑郁的相关性。方法收集2015年3月-2016年1月大连医科大学附属第一医院神经内科就诊的成年癫痫患者93例及正常对照组100名行中文版人际反应指针量表(Interpersonal reactivity index-China,IRI-C)、汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)、汉密尔顿抑郁量表(Hamilton depression scale,HAMD)测查,以及蒙特利尔认知评估量表(Montreal cognitive assessment,Mo CA)进行认知功能测试,分析癫痫患者及不同发作类型、发作频率、发病年限下共情能力的损害及与焦虑抑郁的关系。结果第一,与对照组比较癫痫患者出现分离性共情能力受损,即认知共情受损而情感共情保留,焦虑抑郁也较对照组严重,差异均具有统计学意义;其二,不同发作类型中共情与焦虑抑郁的关系:(1)全面强直-阵挛发作(Generalized tonic-clonic seizure,GTCS)认知共情:无GTCS组、仅有GTCS组、部分性发作继发GTCS(Single partial secondarily SGS)组3组共情总分、情感共情均无统计学意义;SGS组较无GTCS组认知共情能力下降,且焦虑抑郁重,SGS组与仅有GTCS组认知共情无差异,SGS组焦虑抑郁较仅有GTCS组重;无GTCS组与仅有GTCS组比较认知共情、焦虑抑郁均无统计学意义;SGS组情感共情和焦虑抑郁呈显著负相关,无GTCS及仅有GTCS组内共情各项得分与焦虑抑郁无相关性;(2)复杂部分性发作(Complex partial seizure,CPS):CPS组共情总分、认知共情差于无CPS组,焦虑抑郁重于无CPS组,共情总分、情感共情与焦虑抑郁呈显著负相关;无CPS组共情各项与焦虑抑郁无相关性;(3)不同发作频率:高频率组共情总分、认知共情均差于低频率组,焦虑抑郁重于低频率组;情感共情与焦虑抑郁呈显著负相关,共情总分、认知共情与焦虑抑郁无相关性;低频率组共情总分、认知共情、情感共情与焦虑抑郁无相关性;(4)不同发病年限:>5年组共情总分、认知共情较≤5年组差,且焦虑抑郁重;情感共情与焦虑抑郁均呈负相关,共情总分及认知共情与焦虑抑郁无相关性。结论癫痫患者共情能力下降,认知共情损伤,情感共情保留;患者易产生焦虑抑郁;患者情感共情与焦虑抑郁呈负相关,认知共情与焦虑抑郁无相关性;癫痫发作类型、发作频率、发病年限均对认知共情和焦虑抑郁产生影响,并影响情感共情和焦虑抑郁的相关性。
Objective To investigate the impairment of empathic ability and its relationship with anxiety and depression in patients with epilepsy. Methods Ninety-three adult epilepsy patients and 100 normal controls were recruited from March 2015 to January 2016. The interpersonal reactivity index-China (IRI- (C), Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD) test and Montreal cognitive assessment (MoCA) Analysis of epilepsy patients and different types of seizures, seizure frequency, duration of empathy abilities and the relationship with anxiety and depression. Results First, compared with the control group, the patients with epilepsy had impaired separation of empathy, that is, cognitive empathy and emotional empathy retention, anxiety and depression than the control group were also significant differences were statistically significant; Second, (1) Generalized tonic-clonic seizure (GTCS) cognitive empathy: no GTCS group, only GTCS group, partial seizure secondary to GTCS ( There was no significant difference between the two groups in the SGS group (P <0.05). There was no significant difference between the two groups in the SGS group. There was no significant difference between the SGS group and the GTCS group There was no difference between the two groups. There was no significant difference between SGS group and GTCS group. There was no significant difference between GTCS group and GTCS group in cognitive anxiety and anxiety depression. There was a significant negative correlation between emotional empathy and anxiety and depression in SGS group, There was no correlation between the scores of empathy in GTCS group and GTCS group only, and anxiety and depression; (2) Complex partial seizure (CPS): The total score of empathy in CPS group was lower than that of no CPS Group, anxiety and depression were heavier than those without CPS, the total score of empathy, emotional empathy and anxiety and depression were significant (3) The different seizure frequency: the high frequency group, the total score, the cognitive empathy are worse than the low frequency group, the anxiety and depression is heavier than the low frequency group; There was no significant correlation between emotional empathy and anxiety and depression. There was no correlation between empathy score and cognitive empathy and anxiety and depression; low-frequency group empathy score, cognitive empathy, emotional empathy and anxiety and depression had no correlation; (4) different age of onset:> 5 years, the total score of the group empathy, cognitive empathy than ≤ 5-year group differences, and anxiety and depression; emotional empathy and anxiety and depression were negatively correlated, empathy score and cognitive Empathy and anxiety and depression have no correlation. Conclusions Patients with epilepsy have decreased empathy, cognitive empathy and emotional empathy retention. Patients are prone to anxiety and depression. Patients’ emotional empathy is negatively correlated with anxiety and depression. Cognitive empathy is not related to anxiety and depression. Type of seizure , The frequency of seizure and the age of onset all have an impact on cognitive empathy and anxiety and depression, and affect the correlation between emotional empathy and anxiety and depression.