Clinique psychiatrique, CHU de Grenoble, pavillon Dominique-Villars, Grenoble, France.
Rev Neurol (Paris). 2010 May;166(5):515-22. doi: 10.1016/j.neurol.2009.10.016. Epub 2010 Jan 6.
This study compared anxiety and depression in patients presenting with psychogenic non-epileptic seizures (PNES) with those suffering from psychogenic movement disorders (PMD) to assess the link between these psychiatric pathologies and neurological symptoms.
This clinically descriptive, prospective study involved consecutive patients who fulfilled the clinical and video-EEG criteria for PNES and PMD, and who were recruited over an 18-month period. Semi-structured (according to DSM-IV criteria) psychiatric interviews and self-evaluation using the Beck Depression Inventory and Spielberger State-Trait Anxiety Inventory were carried out. Clinical follow-up was conducted 8-12 months after the first evaluation.
A total of 17 patients were recruited: nine presented with PNES; and eight had PMD. Both patient groups had similar demographic and clinical data as well as depression and personality disorders. Although not statistically significant, there was a trend towards an increased prevalence of a familial medical history of epilepsy and a higher incidence of anxiety disorders among patients with PNES.
The data from this prospective study underscore the clinical and psychiatric similarity between PNES and PMD patients. Further studies involving a larger number of subjects should confirm, from a statistical point of view, the differences suggested in the present investigation and, in particular, the greater incidence of anxiety disorders in PNES patients and the presence of an epileptic parent as a risk factor for PNES.
本研究比较了表现为心因性非癫痫性发作(PNES)和心因性运动障碍(PMD)的患者的焦虑和抑郁,以评估这些精神病理学与神经症状之间的联系。
这是一项临床描述性、前瞻性研究,纳入了符合 PNES 和 PMD 的临床和视频脑电图标准并在 18 个月期间招募的连续患者。进行了半结构化(根据 DSM-IV 标准)精神病学访谈和使用贝克抑郁量表和斯皮尔伯格状态-特质焦虑量表进行自我评估。在第一次评估后 8-12 个月进行临床随访。
共招募了 17 名患者:9 名表现为 PNES;8 名患有 PMD。两组患者的人口统计学和临床数据以及抑郁和人格障碍相似。尽管没有统计学意义,但 PNES 患者中癫痫家族病史和焦虑障碍发生率较高的趋势更为明显。
这项前瞻性研究的数据强调了 PNES 和 PMD 患者的临床和精神相似性。进一步的研究应在统计学上证实本研究提出的差异,特别是 PNES 患者焦虑障碍的发生率更高以及癫痫父母作为 PNES 的风险因素。