Northeast Regional Epilepsy Group, 820 Second Avenue, Suite 6C, New York, NY 10017, USA.
Epilepsy Behav. 2013 Jul;28(1):121-6. doi: 10.1016/j.yebeh.2013.03.033. Epub 2013 May 23.
The first objective of this study was to examine and describe the demographic, psychiatric, and trauma characteristics of our sample with PNESs as a whole. Subsequently, a comparison between traumatized and nontraumatized patients with PNESs was performed with regard to descriptive and trauma characteristics and general psychopathology symptoms. Lastly, we analyzed the predictive value in distinguishing patients with "likely" vs. "not likely" PTSD utilizing a model derived from our patients' psychometric test results.
We collected and tallied demographic and psychiatric information and trauma characteristics on 61 patients with PNESs who had confirmed or denied having experienced trauma in their lifetime. We then studied this group with the Trauma Symptom Inventory-2 (TSI-2) and the Minnesota Multiphasic Personality Inventory-2RF (MMPI-2RF). Traumatized patients were subsequently classified as "PTSD likely" and "PTSD not likely" based on TSI-2 criteria and compared on demographic, psychiatric, and trauma characteristics and MMPI-2RF scores.
Our study revealed that 45 out of 61 (73.8%) patients reported experiencing at least one traumatic event in their lifetime. Approximately 40% reported physical or sexual abuse followed in percentage size by loss of a significant other, psychological abuse, witnessing the abuse of others, and medical trauma. Traumatized vs. nontraumatized and "PTSD likely" and "PTSD not likely" patients differed significantly on several clinical variables, as well as MMPI-2RF scores. Scores from TSI-2 produced a model that accurately predicted "no PTSD" in 21/26 (80.77%) subjects who denied a history of PTSD and "PTSD" in 5/6 subjects (83.33%) who endorsed a history of PTSD.
This study showed that overall exposure to psychological trauma is much more prevalent in patients with PNESs than in the general population with an inordinately high exposure to sexual and physical abuse as well as a variety of other types of abuse. Psychopathology was identified in the group with PNESs as a whole with discrete distinctions in clinical symptoms and characteristics of the traumatized as well as the "PTSD likely" subgroups. These findings contribute useful information in understanding intragroup differences in what is increasingly appearing to be a heterogeneous psychiatric condition composed of distinguishable subgroups.
本研究的首要目的是全面研究并描述伴有非癫痫性发作性疾病（PNES）患者的人口统计学、精神科和创伤特征。随后，我们对伴有 PNES 的创伤患者和非创伤患者进行了比较，比较内容包括描述性和创伤特征以及一般精神病理学症状。最后，我们利用源自患者心理测试结果的模型，分析了区分“可能”和“不可能”患有创伤后应激障碍（PTSD）患者的预测价值。
我们收集并统计了 61 名伴有 PNES 患者的人口统计学和精神科信息以及创伤特征，这些患者均已确认或否认一生中经历过创伤。随后，我们使用创伤症状清单-2（TSI-2）和明尼苏达多相人格测验-2RF（MMPI-2RF）对该组患者进行了研究。根据 TSI-2 标准，将创伤患者分为“可能患有 PTSD”和“不可能患有 PTSD”，并对其人口统计学、精神科和创伤特征以及 MMPI-2RF 评分进行比较。
我们的研究表明，61 名患者中有 45 名（73.8%）报告一生中至少经历过一次创伤事件。大约 40%的患者报告遭受过身体或性虐待，其次是失去重要他人、心理虐待、目睹他人虐待和医疗创伤。与非创伤患者以及“可能患有 PTSD”和“不可能患有 PTSD”患者相比，创伤患者在多个临床变量以及 MMPI-2RF 评分上存在显著差异。TSI-2 的分数产生了一个模型，该模型在 26 名否认有 PTSD 病史的受试者中有 21 名（80.77%）准确预测为“无 PTSD”，在 6 名有 PTSD 病史的受试者中有 5 名（83.33%）准确预测为“PTSD”。
本研究表明，伴有 PNES 的患者总体上比普通人群更容易接触到心理创伤，性虐待和身体虐待以及其他各种类型的虐待发生率极高。PNES 患者组被发现存在精神病理学，且创伤患者以及“可能患有 PTSD”亚组患者的临床症状和特征存在明显差异。这些发现为理解日益呈现出的异质性精神疾病提供了有用的信息，该疾病由可区分的亚组组成。
