Baillés Eva, Pintor Luis, Fernandez-Egea Emili, Torres Xavier, Matrai Silvia, De Pablo Joan, Arroyo Santiago
Instituto Clínico de Psiquiatría y Psicología, Hospital Clínico, C/ Villarroel-170, 08036 Barcelona, Spain.
Gen Hosp Psychiatry. 2004 Jul-Aug;26(4):310-5. doi: 10.1016/j.genhosppsych.2004.04.003.
The aim of this study was to examine clinical characteristics in patients with psychogenic nonepileptic seizures and to analyze the Minnesota Multiphasic Personality Inventory (MMPI) profiles and their relation to psychopathology. Thirty patients with nonepileptic seizures confirmed through video-electroencephalography were included. A structured clinical interview (Structured Clinical Interview for DSM-III-R), a measure of personality variables (MMPI), and several structured interviews designed for collecting data on clinical and personal history were administered. Descriptive and comparative statistical methods were used. Of the sample, 67.7% met criteria for two or more simultaneous Axis I diagnoses, and 60% for an Axis II personality disorder. The most frequently elevated scales of the MMPI were Schizophrenia and Depression. There were multiple scale elevations in 12 profiles, the 91.7% of which had elevated "neurotic" and "psychotic" scales. The subgroup with personality disorders showed higher scores on the MMPI Paranoia and Hypomania scales, and the subgroup with traumatic experiences showed higher scores on the MMPI Hypomania scale. Our sample comprising patients with nonepileptic seizures showed a significant degree of psychopathology and absence of a unique character substrate. According to grades of clinical severity of pseudoseizures, several subgroups and different therapeutic implications may be defined.
本研究旨在探讨心因性非癫痫性发作患者的临床特征,并分析明尼苏达多相人格调查表(MMPI)剖面图及其与精神病理学的关系。纳入了30例经视频脑电图证实为非癫痫性发作的患者。采用了结构化临床访谈(DSM-III-R结构化临床访谈)、人格变量测量工具(MMPI)以及几个旨在收集临床和个人史数据的结构化访谈。使用了描述性和比较性统计方法。在样本中,67.7%符合两项或更多同时存在的轴I诊断标准,60%符合轴II人格障碍标准。MMPI中最常升高的量表是精神分裂症量表和抑郁量表。12份剖面图中有多个量表升高,其中91.7%的“神经质”和“精神病性”量表升高。有人格障碍的亚组在MMPI偏执狂量表和轻躁狂量表上得分较高,有创伤经历的亚组在MMPI轻躁狂量表上得分较高。我们纳入非癫痫性发作患者的样本显示出显著程度的精神病理学表现,且不存在独特的性格基础。根据假性发作的临床严重程度等级,可以定义几个亚组和不同的治疗意义。