CSAPA (Health Care Centre of Accompaniment and Prevention in Addictology), University Hospital of Nancy, Nancy, France.
Epilepsy Behav. 2011 Nov;22(3):532-6. doi: 10.1016/j.yebeh.2011.08.015. Epub 2011 Oct 1.
This prospective study investigated and compared psychiatric features of 25 consecutive patients with psychogenic nonepileptic seizures (PNES) on the basis of presence of reported trauma. The "trauma" group comprised 19 patients (76%) and the "no-trauma" group comprised 6 patients (34%). We compared history of PNES, psychiatric comorbidity, alexithymia, and symptoms of dissociation. The study clearly characterized two distinct profiles of patients with PNES on the basis of trauma history. Patients with trauma had at least one psychiatric comorbidity or antecedent (vs 0% in the no-trauma group NT, P<0.001) and a higher median score of dissociation (P<0.001). Patients without trauma had more frequent "frustration situations" as a factor triggering PNES and subsequent sick leaves as perpetuating factors (P=0.001). Trauma antecedents correlated with a high rate of psychiatric comorbidity and a strong dissociative mechanism. Patients without trauma had no psychiatric comorbidity and a weaker dissociative mechanism.
这项前瞻性研究根据报告的创伤情况，调查并比较了 25 例连续的精神性非癫痫性发作（PNES）患者的精神科特征。“创伤”组包括 19 名患者（76%），“无创伤”组包括 6 名患者（34%）。我们比较了 PNES 病史、精神共病、述情障碍和分离症状。该研究基于创伤史明确描绘了具有 PNES 的两种截然不同的患者特征。有创伤的患者至少有一种精神共病或前驱症状（无创伤组 NT 为 0%，P<0.001），且分离症状的中位数评分更高（P<0.001）。无创伤的患者因“挫折情境”作为触发 PNES 的因素和随后的病假作为持续因素更为频繁（P=0.001）。创伤前驱症状与较高的精神共病率和强烈的分离机制相关。无创伤的患者没有精神共病，且分离机制较弱。
