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[综合医院癫痫科转诊的精神性非癫痫发作患者的精神疾病]

[Psychiatric disease in patients with psychogenic non-epileptic seizures referred from an epilepsy unit in a general hospital].

作者信息

Baillès E, Pintor L, Torres X, Fernández-Egea E, de Pablo J, Arroyo S

机构信息

Instituto Clínico de Psiquitatría y Psicología, Hospital Clínic de Barcelona.

出版信息

Actas Esp Psiquiatr. 2004 Mar-Apr;32(2):76-81.

Abstract

INTRODUCTION

We evaluate psychiatric disease associated with psychogenic non-epileptic seizures (PNES) and study the role played by previous traumatic experiences, dissociative episodes and personality disorders.

METHOD

After diagnosing PNES in our epilepsy unit, we obtained a sample of 46 patients and carried out a structured psychiatric interview (SCID) following DSM-III-R criteria. We looked for previous dissociative episodes and prepared a questionnaire for traumatic experiences and basic clinical data.

RESULTS

The most frequent psychiatric disorders were depression, anxiety and somatoform disorders. Personality disorders were found in 16 patients (34.78%), dissociative episodes in 17 (36.95%), and previous traumatic experiences in 14 (30.43%). No statistically significant differences were found in regards to PNES, with respect to presence or absence of previous traumatic experiences, dissociative episodes, and personality disorders.

CONCLUSIONS

As in previous studies, our research project confirms the co-existence of PNES with other mental disorders, and although we do find a higher frequency of seizures, the role played by traumatic experiences and dissociative disorders in CNEP remains unclear.

摘要

引言

我们评估与精神性非癫痫性发作(PNES)相关的精神疾病,并研究既往创伤经历、分离性发作和人格障碍所起的作用。

方法

在我们的癫痫科诊断出PNES后,我们选取了46例患者作为样本,并按照《精神疾病诊断与统计手册》第三版修订版(DSM-III-R)标准进行了结构化精神访谈(SCID)。我们查找既往的分离性发作情况,并编制了一份关于创伤经历和基本临床数据的问卷。

结果

最常见的精神障碍是抑郁、焦虑和躯体形式障碍。16例患者(34.78%)存在人格障碍,17例(36.95%)有分离性发作,14例(30.43%)有既往创伤经历。在PNES方面,有无既往创伤经历、分离性发作和人格障碍,均未发现统计学上的显著差异。

结论

与既往研究一样,我们的研究项目证实了PNES与其他精神障碍并存,尽管我们确实发现发作频率较高,但创伤经历和分离性障碍在精神性非癫痫性发作中所起的作用仍不清楚。

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