Shill Holly, Gerber Paula
Division of Movement Disorders, Barrow Neurological Institute, Phoenix, Arizona, USA.
Mov Disord. 2006 Aug;21(8):1163-8. doi: 10.1002/mds.20921.
Previous studies showed that there are certain features suggestive of a psychogenic disorder, and Fahn and Williams proposed criteria for psychogenic movement disorders. Data on the sensitivity and specificity of these criteria are lacking. We expanded on the Fahn and Williams criteria to create a new set of diagnostic criteria. We retrospectively reviewed 79 patients in a movement disorders specialty clinic. We applied the proposed diagnostic criteria to both cases and controls and analyzed sensitivity and specificity. The diagnostic criteria correctly identified "clinically probable" (or better) psychogenic movement disorders with a sensitivity of 83% and specificity of 100%. For "clinically possible" or greater, sensitivity was 97% and specificity was 96%. In addition, a significantly higher proportion of patients with psychogenic disease were female and reported either a family history of neurological disease or other exposure to neurological disease (P = 0.001 and 0.01, respectively). The diagnostic criteria are simple to apply and have high sensitivity and specificity for psychogenic movement disorders. Also, we report a correlation between previous exposure to a disease model and psychogenic disease.
以往研究表明，存在某些提示精神性障碍的特征，法恩（Fahn）和威廉姆斯（Williams）提出了精神性运动障碍的诊断标准。但缺乏关于这些标准敏感性和特异性的数据。我们对法恩和威廉姆斯的标准进行扩展，制定了一套新的诊断标准。我们对一家运动障碍专科诊所的79例患者进行了回顾性研究。我们将所提出的诊断标准应用于病例组和对照组，并分析了敏感性和特异性。该诊断标准正确识别出“临床很可能”（或更可能）的精神性运动障碍，敏感性为83%，特异性为100%。对于“临床可能”或更高可能性的情况，敏感性为97%，特异性为96%。此外，精神性疾病患者中女性比例显著更高，且报告有神经疾病家族史或其他神经疾病接触史的比例也更高（P值分别为0.001和0.01）。该诊断标准易于应用，对精神性运动障碍具有高敏感性和特异性。此外，我们报告了既往接触疾病模型与精神性疾病之间的相关性。
