目的:COVID-19大流行扰乱了癫痫等慢性疾病的医疗服务。在这项研究中,COVID-19大流行对癫痫患者(PWE)癫痫发作控制的影响,抑郁状态,并评估药物依从性。
方法:经过道德审查,449PWE曾在全印度医学科学研究所(AIIMS)进行过抑郁症评估,新德里,印度,使用Mini国际神经精神病学访谈电话重新评估,并调查了过去6个月的药物来源和药物依从性。抑郁症的患病率和关联,自杀,并确定了不同PWE变量的大流行期间的癫痫发作。
结果:在449个PWE中,70.6%回答。根据MINI诊断为抑郁症阳性的19.9%,而自杀意念的发生率为5.4%。76例(23.9%)PWE报告了大流行期间的癫痫发作。女性发病率更高,失业,以前不受控制的癫痫,综合疗法,改变药物的使用,沮丧的PWE。大流行期间癫痫发作,癫痫发作频率增加,以前的抑郁症史,在COVID-19大流行期间,药物使用的改变都与抑郁症显着相关(2.6-95CI,1.45-4.73;1.9-95CI,1.01-3.57;8.8-95CI,4.54-17.21;2.9-95CI,1.19-7.24),和综合疗法(2.9-95CI,0.92-9.04),大流行期间的癫痫发作(3.9-95CI,1.45-10.53)以及以前的抑郁和自杀史,与自杀意念有关.
结论:COVID-19大流行引起的破坏可能对PWE有害,将服务恢复到preccovid水平,并制定适当的连续性计划来照顾PWE应该是一个优先事项。
OBJECTIVE: COVID-19 pandemic has disrupted healthcare services for chronic disorders such as epilepsy. In this
study, the impact of COVID-19 pandemic on persons with epilepsy (PWE) with regard to their seizure control, depression status, and medication adherence was assessed.
METHODS: After ethical clearance, 449 PWE who had been previously evaluated for depression at All India Institute of Medical Sciences (AIIMS), New Delhi, India, were telephonically revaluated using Mini International Neuropsychiatric Interview and surveyed for source of medication and medication adherence over past 6 months. The prevalence and the association of depression, suicidality, and seizures during pandemic with different PWE variables were determined.
RESULTS: Out of 449 PWE, 70.6% responded. 19.9% were diagnosed positive for depression as per MINI while suicidal ideation was observed in 5.4%. Seventy six (23.9%) PWE reported seizures during pandemic. The incidence was greater in females, unemployed, previously uncontrolled epilepsy, polytherapy, altered use of medications, and depressed PWE. Seizure during pandemic, increased seizure frequency, previous history of depression, and altered use of medications were all significantly associated with depression during COVID-19 pandemic (2.6-95%CI, 1.45-4.73; 1.9-95%CI, 1.01-3.57; 8.8-95%CI, 4.54-17.21; 2.9-95%CI, 1.19-7.24), and polytherapy (2.9-95%CI, 0.92-9.04), seizures during pandemic (3.9-95%CI, 1.45-10.53) and previous history of depression and suicidality, were related with suicidal ideation.
CONCLUSIONS: COVID-19 pandemic-induced disruptions can be detrimental for PWE, and restoring services to the precovid levels as well as putting appropriate continuity plans in place for care of PWE should be a priority.