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伴有或不伴有合并癫痫的精神性非癫痫发作患者的精神障碍

Psychiatric disorders in patients with psychogenic non-epileptic seizures, with and without comorbid epilepsy.

作者信息

D'Alessio Luciana, Giagante Brenda, Oddo Silvia, Silva W Walter, Solís Patrícia, Consalvo Damián, Kochen Silvia

机构信息

Epilepsy Center, Ramos Mejía Hospital, Buenos Aires, Argentina.

出版信息

Seizure. 2006 Jul;15(5):333-9. doi: 10.1016/j.seizure.2006.04.003. Epub 2006 May 23.

Abstract

PURPOSE

The aim of this study is to describe similarities and differences in epidemiological, psychiatric and semiologic variables between patients with psychogenic none epileptic seizures (PNES) and comorbid epilepsy (mixed PNES), and patients with PNES without comorbid epilepsy (pure PNES).

RESULTS

Forty-three patients with PNES diagnosed by Video-EEG were included. Twenty-four had pure PNES, and ninteen mixed PNES. Female population, age, duration of PNES, psychiatric institutionalization, psychopharmacotherapy, dissociative disorders and posttraumatic stress disorder (PTSD), were significantly higher in the pure PNES patients. Suicide attempts, antiepileptic therapy, conversive, affective and personality disorders were frequent in both groups. In the analysis of seizure semiology, the total lack of responsiveness was significantly higher in the mixed PNES group.

CONCLUSIONS

Pure PNES patients showed similarities and differences in the psychiatric profile, with a greater prevalence of dissociative disorders and PTSD, factors related to psychiatric severity.

摘要

目的

本研究旨在描述精神性非癫痫性发作(PNES)合并癫痫(混合性PNES)患者与无合并癫痫的PNES患者(单纯性PNES)在流行病学、精神病学和症状学变量方面的异同。

结果

纳入43例经视频脑电图诊断为PNES的患者。其中24例为单纯性PNES,19例为混合性PNES。单纯性PNES患者的女性比例、年龄、PNES持续时间、精神科住院治疗、心理药物治疗、分离性障碍和创伤后应激障碍(PTSD)显著更高。两组患者自杀未遂、抗癫痫治疗、转换性、情感性和人格障碍均较为常见。在发作症状学分析中,混合性PNES组完全无反应的比例显著更高。

结论

单纯性PNES患者在精神疾病谱方面存在异同,分离性障碍和PTSD的患病率更高,这些因素与精神疾病严重程度相关。

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