Bob Petr, Susta Marek, Pavlat Josef, Hynek Karel, Raboch Jiri
Department of Psychiatry, 1st Faculty of Medicine, Charles University, Prague, Czech Republic.
Neuro Endocrinol Lett. 2005 Aug;26(4):321-5.
According to recent findings trauma and stress are important etiological factors in pathogenesis of depression. As characteristic features of depressive cognition have been reported intrusive thoughts and memory disturbances similar to posttraumatic symptoms known in patients with posttraumatic stress disorder or dissociative disorders. Hypothetically is also suggested a close relationship of traumatic dissociation and epileptic-like phenomena.
In the clinical study were assessed 70 adult people with a diagnosis of depression and 50 healthy controls. In the assessment were used 6 measures for symptoms of dissociation, depression, traumatic stress and psychosenzoric symptoms of epileptic origin (the so-called complex partial seizure-like symptoms).
Reported data show that a great number of depressive patients who met the cut-off score for dissociative disorders (34.2%, N=24) had significantly higher traumatization, depression, subjectively experienced stress and complex partial seizure-like symptoms than the whole group of patients and the controls. Most significant traumatization has been found in patients who met the cut-off score of psychosenzoric epileptic-like symptoms which is characteristic for the epilepsy spectrum disorder (5.7%, N=4).
Significant correlations of these assessed symptoms suggest close relationship between traumatic stress and dissociation in depression. This close relationship of dissociative symptomatology and traumatic stress also implicates an important role of dissociative processes in depression as a typical manifestation of depressive cognition. Assessed relationship between traumatic distress and complex partial seizure-like symptoms suggests a possible role of epileptic-like phenomena in dissociative states related to depression.
Assessed relationship between traumatization, depression and epileptic-like phenomena in the patients who met cut-off score for epilepsy spectrum disorder can contribute to the problem of indication of several depressive patients to anticonvulsant therapy because of reported evidence that a clear majority of patients with epilepsy spectrum disorder respond well to anticonvulsant treatment. Careful assessment of this test battery thus may be useful also for anticonvulsant treatment strategy.
根据最近的研究结果，创伤和应激是抑郁症发病机制中的重要病因。据报道，抑郁认知的特征性表现包括侵入性思维和记忆障碍，类似于创伤后应激障碍或解离性障碍患者的创伤后症状。此外，还假设创伤性解离与癫痫样现象之间存在密切关系。
在这项临床研究中，评估了70名诊断为抑郁症的成年人和50名健康对照者。评估采用了6种测量方法，分别用于测量解离症状、抑郁症状、创伤应激症状以及癫痫起源的心理感觉症状（所谓的复杂部分性发作样症状）。
报告的数据显示，大量符合解离性障碍截断分数的抑郁症患者（34.2%，N = 24）的创伤程度、抑郁程度、主观感受到的应激以及复杂部分性发作样症状显著高于整个患者组和对照组。在符合癫痫谱系障碍特征的心理感觉癫痫样症状截断分数的患者中发现了最显著的创伤（5.7%，N = 4）。
这些评估症状之间的显著相关性表明，创伤应激与抑郁症中的解离之间存在密切关系。解离症状学与创伤应激之间的这种密切关系也暗示了解离过程在抑郁症中作为抑郁认知典型表现的重要作用。创伤性困扰与复杂部分性发作样症状之间的评估关系表明，癫痫样现象在与抑郁症相关的解离状态中可能发挥作用。
在符合癫痫谱系障碍截断分数的患者中，创伤、抑郁和癫痫样现象之间的评估关系可能有助于解决一些抑郁症患者因有证据表明绝大多数癫痫谱系障碍患者对抗惊厥治疗反应良好而接受抗惊厥治疗的指征问题。因此，仔细评估这套测试方法可能对抗惊厥治疗策略也有用。
