评估德拉沃综合征相关神经精神并发症(DANCE)的工具

IF 2.3 3区 医学 Q2 BEHAVIORAL SCIENCES
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引用次数: 0

摘要

德雷维特综合征(Dravet Syndrome,DS)是一种罕见的严重癫痫,起病于婴儿期,主要由致病基因变异引起。Dravet 综合征的特点是长期和频繁的耐药性癫痫发作,以及发育迟缓和行为问题。这些并发症的识别基于临床访谈,并依赖于医疗保健专业人员(HCP)的经验。我们召集了一批专业的医护人员和护理人员,创建了一份筛查清单,用于评估 DS 相关的神经精神疾病合并症 (DANC)。检查表包括与认知和精神领域、运动技能以及 DS 对家庭日常生活的影响相关的问题。我们对来自比利时、法国和西班牙的 24 位 DS 患者的照顾者进行了问卷调查。试用后,我们从专业的保健医生和护理人员那里获得了反馈意见,从而完善了核对表。DS 患者表现出一系列与 DS 相关的神经精神症状。最常见的认知领域症状是注意力困难、多任务处理问题(18/24 名护理人员)和冲动(17/24 名),而最常见的精神症状是脾气暴躁(14/24 名)、情绪波动(13/24 名)和自闭症谱系障碍(12/24 名)。几乎所有患者都有平衡和协调问题,只有 4/23 例患者可以完全行动自如。大多数患者在生活自理和进食方面依赖他人,并出现睡眠障碍。护理人员表示,家庭中兄弟姐妹和父母之间的压力都很大。结果显示,父母主要关注的是 DS 患者的行为和认知能力。定量反馈结果显示,检查表的实用性、易完成性、清晰度和全面性从良好到非常好。这项试点研究表明,DANCE核对表可以作为一种有用的筛查工具,用于神经精神疾病合并症的日常诊断和治疗,并增强护理人员和患者的能力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A tool for Dravet syndrome-associated neuropsychiatric comorbidities evaluation (DANCE)

Background

Dravet syndrome (DS) is a rare and severe form of epilepsy that begins in infancy, which is primarily caused by pathogenic variants in the SCN1A gene. DS is characterized by prolonged and frequent drug-resistant seizures, as well as developmental delays and behavioral problems. The identification of these comorbidities is based on clinical interview and relies on healthcare professionals (HCPs) experience.

Methods

We assembled a group of expert HCPs and caregivers to create a screening checklist for assessing DS-Associated Neuropsychiatric Comorbidities (DANC). The checklist includes questions related to cognitive and psychiatric domains, motor skills, and the impact of DS on families’ daily lives. We administered the checklist to 24 caregivers of DS patients from Belgium, France, and Spain. After piloting, we obtained feedback from expert HCPs and caregivers to refine the checklist.

Results

DS patients showed a wide array of neuropsychiatric symptoms related to DS. The most common cognitive domains reported were attention difficulties and multitasking problems (18/24 caregivers), and impulsivity (17/24), while the most common psychiatric symptoms were temper tantrums (14/24), mood swings (13/24) and autism spectrum disorder (12/24). Balance and coordination problem have been reported in almost all patients with a statement of only 4/23 with complete mobility. Most patients were dependent on others for self-care and eating, and presented sleeping disturbances. Caregivers reported high levels of stress in the family unit, both between siblings and parents. Results show that the main concerns of parents were the behavior and the cognition of the person with DS. The quantitative feedback results showed good-to-very good scores on usefulness, ease of completion, clarity and comprehensiveness of the checklist.

Conclusions

This pilot study suggests that the DANCE checklist could be a useful screening tool in daily practice for neuropsychiatric comorbidities facilitating their diagnosis and treatment, and empowering both caregivers and patients.

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来源期刊
Epilepsy & Behavior
Epilepsy & Behavior 医学-行为科学
CiteScore
5.40
自引率
15.40%
发文量
385
审稿时长
43 days
期刊介绍: Epilepsy & Behavior is the fastest-growing international journal uniquely devoted to the rapid dissemination of the most current information available on the behavioral aspects of seizures and epilepsy. Epilepsy & Behavior presents original peer-reviewed articles based on laboratory and clinical research. Topics are drawn from a variety of fields, including clinical neurology, neurosurgery, neuropsychiatry, neuropsychology, neurophysiology, neuropharmacology, and neuroimaging. From September 2012 Epilepsy & Behavior stopped accepting Case Reports for publication in the journal. From this date authors who submit to Epilepsy & Behavior will be offered a transfer or asked to resubmit their Case Reports to its new sister journal, Epilepsy & Behavior Case Reports.
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