儿童和青少年抗N-甲基-D-天冬氨酸受体脑炎的病程和心理社会结果。

Clinical child psychology and psychiatry Pub Date : 2024-04-01 Epub Date: 2023-11-01 DOI:10.1177/13591045231211963
Joke Depreitere, Inge Antrop, Helene Verhelst
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引用次数: 0

摘要

目的:探讨儿童和青少年抗N-甲基-D-天冬氨酸受体脑炎(抗NMDARE)后的心理社会结果以及持续缺陷对生活质量(QoL)和整体功能的影响。方法:4名女性患者(年龄7-16y)及其护理人员参与研究。通过问卷调查从医疗记录和护理人员那里收集信息。采用DSM-5初级版(SCID-5初级版)结构化临床访谈的方式对患者及其护理人员进行访谈。定义CGAS和mRS评分,并使用儿科生活质量量表(PedsQL)评估患者和护理人员的生活质量。结果和结论:在疾病的急性期后,患者会经历一个急性期后阶段,在接下来的几个月到一年中,一些持续的身体、认知和精神症状逐渐缓解。在长期随访中,这些症状部分缓解,但在几个领域仍存在缺陷。在目前的评估中,四分之三的患者出现精神症状、疲劳和轻度认知缺陷。三名患者的学习轨迹发生了改变。这些缺陷可能会影响患者和护理人员的生活质量和全球功能。
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Disease course and psychosocial outcome for children and adolescents with anti-N-methyl-D-aspartate receptor encephalitis.

Objectives: Explore psychosocial outcome and impact of persisting deficits on quality of life (QoL) and global functioning after anti-N-methyl-D-aspartate receptor encephalitis (anti-NMDARE) in children and adolescents.

Methods: Four female patients (age 7-16y) and their caregivers participated in the study. Information was collected from the medical records and the caregivers via a questionnaire. Both the patients and their caregivers were interviewed by means of the structured clinical interview for DSM-5 disorders, junior version (SCID-5 junior). CGAS and mRS scores were defined and the Pediatric Quality of Life Inventory (PedsQL) was used to assess quality of life of patients and caregivers.

Results and conclusion: After the acute phase of the disease patients go through a post-acute phase in which several persisting physical, cognitive and psychiatric symptoms gradually resolve during the following months to a year. In long-term follow up these symptoms partly resolved, but deficits persisted on several domains. Psychiatric symptoms, fatigue and mild cognitive deficits were present in three out of four patients at current assessment. In three patients their academic trajectory was altered. These deficits can have an impact on the quality of life and the global functioning of the patients and caregivers.

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