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患有转换障碍的土耳其住院患者中的分离性障碍

Dissociative disorders in Turkish inpatients with conversion disorder.

作者信息

Tezcan Ertan, Atmaca Murad, Kuloglu Murat, Gecici Omer, Buyukbayram Ayten, Tutkun Hamdi

机构信息

Firat University, School of Medicine, Department of Psychiatry, Elazig, Turkey.

出版信息

Compr Psychiatry. 2003 Jul-Aug;44(4):324-30. doi: 10.1016/S0010-440X(03)00087-7.

Abstract

The aim of our study was to determine the frequency of dissociative disorders (DDs) among inpatients with conversion disorder (CD) in a university clinic settled in Eastern Turkey. During a period of 24 months, 59 consecutively admitted adult CD patients were screened with the Dissociative Experience Scale (DES). Patients who scored above 30 (DDs group) did not differ by age or gender from a group of inpatients who scored below 10 on the scale (comparison group). All patients in the two groups were then interviewed in a blind manner using the Dissociative Disorders Interview Schedule (DDIS) and Structured Interview for DSM-IV Dissociative Disorders (SCID-D). According to the SCID-D, 18 of 59 patients (30.5%) received a diagnosis of dissociative disorder; nine of these 18 patients (50%) were diagnosed as having dissociative identity disorder, eight (44.4%) were diagnosed as having dissociative disorder not otherwise specified (NOS), and one (5.6%) was diagnosed as having dissociative amnesia. Accordingly to the DDIS, borderline personality disorder was frequent in the DDs group, and all of the patients in the DDs group reported sexual abuse and neglect during childhood, latency, or adolescence. A high proportion of CD patients have significant dissociative pathology. The proper diagnosis of these patients has important implications for their clinical course.

摘要

我们研究的目的是确定在土耳其东部一家大学诊所中,患有转换障碍(CD)的住院患者中分离性障碍(DDs)的发生率。在24个月的时间里,我们使用分离体验量表(DES)对59例连续入院的成年CD患者进行了筛查。量表得分高于30分的患者(DDs组)在年龄或性别上与量表得分低于10分的住院患者组(对照组)没有差异。然后,使用分离性障碍访谈量表(DDIS)和DSM-IV分离性障碍结构化访谈(SCID-D)对两组所有患者进行盲法访谈。根据SCID-D,59例患者中有18例(30.5%)被诊断为分离性障碍;这18例患者中有9例(50%)被诊断为分离性身份障碍,8例(44.4%)被诊断为未特定的分离性障碍(NOS),1例(5.6%)被诊断为分离性遗忘症。根据DDIS,边缘性人格障碍在DDs组中很常见,并且DDs组的所有患者都报告在童年、潜伏期或青春期遭受过性虐待和忽视。高比例的CD患者存在明显的分离性病理。对这些患者进行正确诊断对其临床病程具有重要意义。

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