与癫痫相比，心理性非癫痫发作中的精神共病情况。

Psychiatric comorbidity in psychogenic nonepileptic seizures compared with epilepsy.

作者信息

Diprose William, Sundram Frederick, Menkes David B

机构信息

Whangarei Hospital, Private Bag 9742, Whangarei 0148, New Zealand.

Department of Psychological Medicine, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.

出版信息

Epilepsy Behav. 2016 Mar;56:123-30. doi: 10.1016/j.yebeh.2015.12.037. Epub 2016 Feb 11.

DOI:10.1016/j.yebeh.2015.12.037

PMID:26874243

Abstract

OBJECTIVES

Psychogenic nonepileptic seizures (PNESs) are closely linked with psychological distress, but their etiology is not well-understood. We reviewed psychiatric comorbidity in PNESs and epileptic seizures (ESs) with an aim to assist understanding, diagnosis, and management of PNESs.

METHODS

A search of Web of Science, MEDLINE (PubMed), PsycINFO, and Scopus identified 32 relevant studies on the prevalence of psychiatric comorbidity in PNESs. We used meta-analysis to compare psychiatric comorbidity between PNESs and ESs.

RESULTS

Samples with PNESs had high rates of psychiatric comorbidity overall (53-100%), notably including posttraumatic stress disorder (PTSD), depression, and personality and anxiety disorders. Compared with ESs, samples with PNESs had more psychiatric comorbidity overall (RR: 1.30, 95% CI: 1.14-1.48, p<0.0001) with significantly elevated risks found for PTSD, personality disorder, and anxiety but not depression.

CONCLUSIONS

Psychiatric disorders are more common in PNESs than ESs. Because of methodological limitations of available studies, causality cannot be established; prospective longitudinal designs are required.

摘要

目的

心理性非癫痫发作（PNES）与心理困扰密切相关，但其病因尚未完全明确。我们回顾了PNES和癫痫发作（ES）中的精神共病情况，旨在帮助理解、诊断和管理PNES。

方法

通过检索科学网、MEDLINE（PubMed）、PsycINFO和Scopus，确定了32项关于PNES中精神共病患病率的相关研究。我们使用荟萃分析来比较PNES和ES之间的精神共病情况。

结果

总体而言，PNES样本的精神共病率较高（53%-100%），尤其包括创伤后应激障碍（PTSD）、抑郁症以及人格和焦虑障碍。与ES相比，PNES样本的总体精神共病更多（风险比：1.30，95%置信区间：1.14-1.48，p<0.0001），其中PTSD、人格障碍和焦虑的风险显著升高，但抑郁症风险未升高。