青少年癫痫患者病耻感与心理弹性的关系及相关因素分析

杨蔚蔚; 芮忠洋; 李彪; 陈静

doi:10.16835/j.cnki.1000-9817.2025079

青少年癫痫患者病耻感与心理弹性的关系及相关因素分析

doi: 10.16835/j.cnki.1000-9817.2025079

武汉市精神卫生中心精神科，湖北 430012

基金项目:

湖北省卫生健康委员会科研项目 WJ2023M141

详细信息

作者简介:
杨蔚蔚(1986-)，女，安徽蚌埠人，大学本科，主治医师，主要研究方向为临床精神病学和心理学

通讯作者:
李彪，E-mail：lbpsy2016@163.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 B844.2 R742.1
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- 被引次数: 0
出版历程
- 收稿日期: 2024-12-18
- 修回日期: 2025-02-05
- 网络出版日期: 2025-04-03
- 刊出日期: 2025-03-25

Analysis of the relationship between stigma and mental resilience in adolescent patients

Department of Psychiatry, Wuhan Mental Health Center, Wuhan (430012), Hubei Province, China

摘要

摘要: 目的探讨青少年癫痫患者病耻感和心理弹性的关系及其相关因素，为开展青少年癫痫患者心理干预提供参考。方法选取2021年2月—2024年10月武汉市精神卫生中心接收的295例青少年癫痫患者作为研究对象，采用Kilifi癫痫患者羞耻感中文量表(KSSE)评估患者病耻感，采用心理韧性量表(CD-RISC)评估患者心理弹性。采用多因素Logistic回归分析青少年癫痫患者病耻感和心理弹性的相关因素。结果青少年癫痫患者KSSE评分为(10.90±4.13)分，138例(46.78%)低水平，154例(52.20%)中水平，3例(1.02%)高水平；CD-RISC评分为(50.19±5.97)分，170例(57.63%)低水平，125例(42.37%)高水平。多因素Logistic回归分析结果显示，病程＞3年(OR=2.22)、有癫痫家族史(OR=4.18)、家庭月收入≤5 000元(OR=2.05)、单亲家庭(OR=2.46)、中高水平病耻感(OR=1.72)的青少年癫痫患者出现低水平心理弹性风险更高；病程＞3年(OR=2.20)、有癫痫家族史(OR=3.54)、全面性发作(OR=2.12)、家庭月收入≤5 000元(OR=2.70)、低水平心理弹性(OR=2.03)的青少年癫痫患者出现中高水平病耻感风险更高(P值均 < 0.05)。结论青少年癫痫患者病耻感水平较高、心理弹性较低，临床可基于青少年癫痫病患者病耻感的相关因素开展针对性心理干预。
- 癫痫 /
- 羞耻 /
- 精神卫生 /
- 弹性 /
- 回归分析 /
- 青少年
Abstract: Objective To explore the relationship between stigma and mental resilience in adolescent epilepsy patients and associated factors, so as to provide reference for future psychological intervention in adolescent patients with epilepsy. Methods A total of 295 adolescent patients with epilepsy from Wuhan Mental Health Center were enrolled as participants from February 2021 to October 2024. The stigma was evaluated by Kilifi Stigma Scale for Epilepsy (KSSE), and psychological resilience was evaluated by Connor-Davidson Resilience Scale (CD-RISC). Associated factors of stigma and psychological resilience in adolescent patients with epilepsy were analyzed by multivariate Logistic regression analysis. Results In the adolescent patients with epilepsy, KSSE score was (10.90±4.13) points, with 138 cases (46.78%) at low level, 154 cases (52.20%) at moderate level and 3 cases (1.02%) at high level. CD-RISC score was (50.19±5.97) points, there were 170 cases (57.63%) at low level and 125 cases (42.37%) at high level. Multivariate Logistic regression analysis showed that disease course >3 years (OR=2.22), family history of epilepsy (OR=4.18), monthly family income ≤5 000 yuan (OR=2.05), single parent family (OR=2.46) and middle and high stigma level (OR=1.72) had a higher risk on low level of mental resilience (P < 0.05). The course of disease >3 years (OR=2.20), family history of epilepsy (OR=3.54), general seizure (OR=2.12), monthly family income ≤5 000 yuan (OR=2.70), low level of mental resilience (OR=2.03) of adolescent epilepsy patients showed a high risk on moderate-high level of stigma (P < 0.05). Conclusions The stigma level is higher, while psychological resilience is lower in adolescent patients with epilepsy. Clinically, targeted intervention should be implemented based on related factors such as stigma in addescent patients with epilepsy.
- Epilepsy /
- Shame /
- Mental health /
- Elasticity /
- Regression analysis /
- Adolescent
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表 1 青少年癫痫患者心理弹性和病耻感的单因素分析

Table 1. Univariate analysis of psychological resilience and stigma in adolescent patients with epilepsy

因素	选项	人数	心理弹性				病耻感
因素	选项	人数	低水平	高水平	χ²值	P值	中高水平	低水平	χ²值	P值
性别	男	163	93(57.06)	70(42.94)	0.05	0.83	84(51.53)	79(48.47)	0.42	0.52
	女	132	77(58.33)	55(41.67)			73(55.30)	59(44.70)
年龄/岁	>15~18	212	114(53.77)	98(46.23)	4.56	0.03	116(54.72)	96(45.28)	0.77	0.38
	13~15	83	56(67.47)	27(32.53)			41(49.40)	42(50.60)
文化程度	初中及以下	108	59(54.63)	49(45.37)	0.63	0.43	54(50.00)	54(50.00)	0.71	0.4
	高中及以上	187	111(59.36)	76(40.64)			103(55.08)	84(44.92)
病程/年	>3	106	74(69.81)	32(30.19)	10.06	< 0.01	69(65.09)	37(34.91)	9.37	< 0.01
	≤3	189	96(50.79)	93(49.21)			88(46.56)	101(53.44)
独生子女	有	178	98(55.06)	80(44.94)	1.22	0.27	97(54.49)	81(45.51)	0.29	0.59
	无	117	72(61.54)	45(38.46)			60(51.28)	57(48.72)
户籍所在地	农村	157	89(56.69)	68(43.31)	0.12	0.73	95(60.51)	62(39.49)	7.16	< 0.01
	城镇	138	81(58.70)	57(41.30)			62(44.93)	76(55.07)
癫痫家族史	有	18	15(83.33)	3(16.67)	5.19	0.02	14(77.78)	4(22.22)	4.64	0.03
	无	277	155(55.96)	122(44.04)			143(51.62)	134(48.38)
发作类型	全面发作	69	45(65.22)	24(34.78)	2.13	0.15	47(68.12)	22(31.88)	8.03	< 0.01
	局灶性/混合性发作	226	125(55.31)	101(44.69)			110(48.67)	116(51.33)
家庭月收入/元	>5 000	191	99(51.83)	92(48.17)	7.45	0.01	87(45.55)	104(54.45)	12.80	< 0.01
	≤5 000	104	71(68.27)	33(31.73)			70(67.31)	34(32.69)
家庭结构	正常家庭	242	131(54.13)	111(45.87)	6.74	0.01	125(51.65)	117(48.35)	1.33	0.25
	单亲家庭	53	39(73.58)	14(26.42)			32(60.38)	21(39.62)
病耻感	中高水平	157	102(64.97)	55(35.03)	7.41	0.01
	低水平	138	68(49.28)	70(50.72)
心理弹性	低水平	170					102(60.00)	68(40.00)	7.41	< 0.01
	高水平	125					55(44.00)	70(56.00)
注： ()内数字为构成比/%。

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表 2 青少年癫痫患者心理弹性相关因素的多因素Logistic回归分析(n=295)

Table 2. Multivariate Logistic regression analysis of related factors of psychological resilience in adolescent patients with epilepsy(n=295)

自变量	β值	标准误	Wald χ²值	OR值(95%CI)	P值
年龄13~15岁	0.03	0.28	0.01	1.03(0.60~1.78)	0.90
病程＞3年	0.80	0.27	9.06	2.22(1.32~3.74)	< 0.01
有癫痫家族史	1.43	0.67	4.55	4.18(1.12~15.56)	0.03
家庭月收入≤5 000元	0.72	0.27	7.05	2.05(1.21~3.46)	0.01
单亲家庭	0.90	0.35	6.57	2.46(1.24~4.88)	0.01
中高水平病耻感	0.54	0.20	7.31	1.72(1.16~2.55)	< 0.01

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表 3 青少年癫痫患者病耻感相关因素的多因素Logistic回归分析(n=295)

Table 3. Multivariate Logistic regression analysis of related factors of stigma in adolescent patients with epilepsy(n=295)

自变量	β值	标准误	Wald χ²值	OR值(95%CI)	P值
病程＞3年	0.79	0.27	8.47	2.20(1.29~3.74)	< 0.01
有癫痫家族史	1.27	0.62	4.18	3.54(1.05~11.92)	0.04
全面性发作	0.75	0.31	5.88	2.12(1.15~3.88)	0.02
家庭月收入≤5 000元	0.99	0.27	13.49	2.70(1.59~4.59)	< 0.01
低水平心理弹性	0.71	0.26	7.62	2.03(1.23~3.36)	< 0.01

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