Int J Psychiatry Med. 2014;47(1):41-53. doi: 10.2190/PM.47.1.d.
Children and adolescents with psychogenic non-epileptic seizures (PNES) and epilepsy are known to have psychosocial problems. The aim of the present study was to compare the psychosocial difficulties, history of stressful life events/abuse, psychiatric diagnosis, and self-esteem of adolescents with PNES to the ones with epilepsy and healthy controls at a tertiary care center in Turkey.
Thirty-four adolescents with PNES diagnosed by video-EEG were compared with 23 adolescents that have epilepsy and 35 healthy volunteers. Comorbid psychiatric diagnoses of participants were examined by semi-structured interviews using Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (KSADS-PL). Self-esteem of adolescents was evaluated by Rosenberg Self Esteem Scale (RSES).
No differences in sociodemographic features were observed between the groups. The PNES group showed significantly higher rates of parental conflicts, difficulties in relationship with siblings/peers, school under-achievement, and history of stressful events/abuse. The rates of comorbid psychiatric disorders were 64.7% in PNES and 47.8% in epilepsy group. The most common disorders in both groups were attention deficit hyperactivity disorder (ADHD) and depressive disorder. The rate of posttraumatic stress disorder (PTSD) was significantly increased in the PNES group. Additionally, adolescents with PNES displayed significantly lower levels of self-esteem than the other groups.
It could be concluded that both disorders involved a high risk for developing psychiatric disorders; additionally, adolescents with PNES have higher rates of stressors and lower levels of self-esteem. Findings from this investigation point to the importance of psychiatric interventions in pediatric PNES and also epilepsy.
已知患有心因性非癫痫性发作(PNES)和癫痫的儿童和青少年存在心理社会问题。本研究的目的是在土耳其的一家三级保健中心比较 PNES 青少年与癫痫青少年和健康对照组的心理社会困难、压力生活事件/虐待史、精神科诊断和自尊。
将 34 名经视频-EEG 诊断为 PNES 的青少年与 23 名患有癫痫的青少年和 35 名健康志愿者进行比较。使用儿童时期情感障碍和精神分裂症的半定式访谈表(KSADS-PL)对参与者的合并精神科诊断进行检查。通过罗森伯格自尊量表(RSES)评估青少年的自尊。
各组间的社会人口学特征无差异。PNES 组表现出更高的父母冲突、与兄弟姐妹/同伴关系困难、学业成绩不佳和压力事件/虐待史的发生率。合并精神障碍的发生率在 PNES 组为 64.7%,在癫痫组为 47.8%。两组最常见的疾病是注意缺陷多动障碍(ADHD)和抑郁症。创伤后应激障碍(PTSD)在 PNES 组的发生率明显增加。此外,PNES 青少年的自尊水平明显低于其他组。
可以得出结论,这两种疾病都存在发生精神障碍的高风险;此外,PNES 青少年的压力源发生率更高,自尊水平更低。这项研究的结果表明,对儿科 PNES 和癫痫患者进行精神干预非常重要。