与神经疾病相比，功能性神经症状障碍中亲属和患者疾病认知的差异。
Differences in relatives' and patients' illness perceptions in functional neurological symptom disorders compared with neurological diseases.
作者信息
Whitehead Kimberley, Stone Jon, Norman Paul, Sharpe Michael, Reuber Markus
机构信息
Department of Clinical Neurophysiology, Royal Hallamshire Hospital, Sheffield S10 2JF, UK.
Dept Clinical Neurosciences, University of Edinburgh, Western General Hospital, Crewe Rd, Edinburgh, EH4 2XU, UK.
出版信息
Epilepsy Behav. 2015 Jan;42:159-64. doi: 10.1016/j.yebeh.2014.10.031. Epub 2014 Dec 13.
OBJECTIVE
The illness perceptions of the relatives of patients with functional neurological symptom disorders (FNSDs) and their relation to the illness perceptions of the patients have been little studied. We aimed to compare illness perceptions of relatives of patients with FNSDs with those held by patients themselves. We used control pairs with neurological diseases (NDs) to examine the specificity of the findings to FNSDs.
MATERIAL AND METHODS
Patients with FNSDs (functional limb weakness and psychogenic nonepileptic seizures) and patients with NDs causing limb weakness and epilepsy, as well as their relatives, completed adapted versions of the Illness Perception Questionnaire - Revised (IPQ-R).
RESULTS
We included 112 pairs of patients with FNSDs and their relatives and 60 pairs of patients with NDs and their relatives. Relatives of patients with FNSDs were more likely to endorse psychological explanations and, in particular, stress as causal factors than patients with FNSDs (p<.001). Relatives of patients with FNSDs were also more pessimistic about the expected duration of the disorder and perceived a greater emotional impact compared with patients themselves (p<.001). However, the latter two differences between patients and relatives were also found in pairs of patients with NDs and their relatives.
CONCLUSION
The main difference in illness perceptions between relatives and patients that appeared specific to FNSDs was a tendency for relatives to see psychological factors as more relevant compared with patients. Some other differences were observed between pairs of patients with FNSDs and their relatives, but the same differences were also seen in pairs of patients with NDs and their relatives. These other differences were, therefore, not specific to FNSDs. Discussion about possibly relevant psychological factors with patients suffering from FNSDs may be helped by including relatives.
目的
功能性神经症状障碍（FNSDs）患者亲属的疾病认知及其与患者疾病认知的关系鲜有研究。我们旨在比较FNSDs患者亲属与患者自身的疾病认知。我们使用患有神经系统疾病（NDs）的对照配对来检验这些发现对FNSDs的特异性。
材料与方法
患有FNSDs（功能性肢体无力和精神性非癫痫性发作）的患者、导致肢体无力和癫痫的NDs患者及其亲属，完成了修订版疾病认知问卷（IPQ-R）的改编版本。
结果
我们纳入了112对FNSDs患者及其亲属以及60对NDs患者及其亲属。与FNSDs患者相比，FNSDs患者的亲属更倾向于认可心理因素，尤其是压力作为致病因素（p<0.001）。与患者自身相比，FNSDs患者的亲属对疾病预期持续时间也更悲观，且感知到更大的情感影响（p<0.001）。然而，患者与亲属之间的后两个差异在患有NDs的患者及其亲属配对中也有发现。
结论
亲属与患者之间在疾病认知上的主要差异，似乎是FNSDs特有的，即亲属比患者更倾向于认为心理因素更相关。在FNSDs患者及其亲属配对之间还观察到了其他一些差异，但在NDs患者及其亲属配对中也出现了同样的差异。因此，这些其他差异并非FNSDs所特有。让亲属参与进来，可能有助于与患有FNSDs的患者讨论可能相关的心理因素。
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