Schulze A, Jacob H W, Guckler A
Klinik für Psychiatrie des Zentrums für Nervenheilkunde der Charité.
Psychother Psychosom Med Psychol. 1992 Jun;42(6):201-5.
As there is a variety of psychic and somatic variables in its genesis, the writer's cramp could be a syndrome of different subtypes. Therefore 62 former psychotherapy-patients with writer's cramp were examined according to a design of several dimensions in order to find out if there were any subtypes. The parts of the examination were exploration, structural interview, neurological examination, psychological examination of the personality, examination of some electrolytes in serum and radiograph of neck spinal column. Different multivariate statistical methods isolated two subtypes of patients with writer's cramp. The first group comprises patients with fine and/or big dysfunctions of motor activity, the symptoms are independent of psychic factors or of psychotherapy. The second group is characterized of a monosymtomatic writer's cramp, of a neurosis and of remissions of motoric symptoms following psychotherapy. The examination shows that fine and/or big dysfunctions of motor activity which often co-occur the writer's cramp are important criteria for differential diagnosis and indications.
由于书写痉挛的成因涉及多种心理和躯体变量,它可能是一种具有不同亚型的综合征。因此,按照多维度设计对62名曾患有书写痉挛的心理治疗患者进行了检查,以确定是否存在亚型。检查内容包括探索、结构化访谈、神经学检查、人格心理检查、血清中某些电解质的检查以及颈部脊柱X光检查。不同的多元统计方法分离出了书写痉挛患者的两种亚型。第一组患者存在精细和/或粗大运动功能障碍,症状与心理因素或心理治疗无关。第二组的特征是单一症状的书写痉挛、神经症以及心理治疗后运动症状缓解。检查表明,经常与书写痉挛同时出现的精细和/或粗大运动功能障碍是鉴别诊断和适应症的重要标准。