Cragar Dona E, Schmitt Frederick A, Berry David T R, Cibula Jean E, Dearth Chantel M S, Fakhoury Toufic A
Department of Psychology, University of Kentucky, Lexington, KY, USA.
J Clin Exp Neuropsychol. 2003 Sep;25(6):793-804. doi: 10.1076/jcen.25.6.793.16471.
The differential diagnosis of epileptic seizures (ES) and psychogenic nonepileptic seizures (PNES) continues to be a common concern in epilepsy treatment centers. The MMPI/MMPI-2 is the most commonly studied psychological measure in the differential diagnosis of ES and PNES. Wilkus, Dodrill, and Thompson (1984) and Derry and McLachlan (1996) both developed decision rules for use with the MMPI and MMPI-2 to assist in this diagnostic discrimination. Both sets of decision rules were evaluated in a sample of ES (n=58), PNES ( n=29) and epilepsy plus PNES (n=19) patients. Validity of the epilepsy diagnosis was established with 24-hr video-EEG monitoring in all cases. The two sets of decision rules applied to the MMPI-2 showed sensitivities of 68% and 48% and specificity values of 55% and 58%. Calculation of positive and negative predictive power for both sets of rules at three different base rates suggests that use of these rules can result in a large number of false positive diagnoses of PNES.
癫痫发作（ES）与精神性非癫痫性发作（PNES）的鉴别诊断一直是癫痫治疗中心普遍关注的问题。明尼苏达多相人格调查表/MMPI-2是ES和PNES鉴别诊断中研究最广泛的心理测量工具。威尔克斯、多德里尔和汤普森（1984年）以及德里和麦克拉克伦（1996年）都制定了与MMPI和MMPI-2配合使用的决策规则，以辅助进行这种诊断鉴别。在一组由ES患者（n = 58）、PNES患者（n = 29）和癫痫合并PNES患者（n = 19）组成的样本中，对这两组决策规则进行了评估。所有病例均通过24小时视频脑电图监测确定癫痫诊断的有效性。应用于MMPI-2的两组决策规则的敏感度分别为68%和48%，特异度值分别为55%和58%。在三种不同先验概率下对两组规则的阳性和阴性预测能力进行计算，结果表明使用这些规则可能导致大量对PNES的假阳性诊断。
