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器质性与功能性神经障碍:儿童期心理创伤的作用。

Organic vs. functional neurological disorders: The role of childhood psychological trauma.

机构信息

Edinburgh Napier University, School of Health & Social Care, Edinburgh, UK; NHS Lothian, Rivers Centre for Traumatic Stress, Edinburgh, UK.

Edinburgh Napier University, School of Health & Social Care, Edinburgh, UK.

出版信息

Child Abuse Negl. 2017 Jan;63:1-6. doi: 10.1016/j.chiabu.2016.11.011. Epub 2016 Nov 22.

Abstract

Although the relationship between psychological trauma and medically unexplained symptoms (MUS) is well established, this relationship is less well understood in people with medically unexplained neurological symptoms. In the present study, we set out to compare people with functional neurological disorders, and organic neurological disorders, in terms of childhood and adulthood traumatic events, traumatic stress, emotional dysregulation and symptoms of depression and anxiety. We have hypothesised that those with functional neurological disorders would be more likely to report childhood and adulthood traumatic life events, traumatic symptomatology, emotional dysregulation and symptoms of anxiety and depression, compared to those with organic neurological disorders. Sample consisted of a consecutive series of people with functional neurological disorders and with organic neurological disorders (n=82) recruited from a hospital in Scotland. Participants completed measures of life events, traumatic stress, emotional regulation, anxiety and depression. The two groups were found to significantly differ in relation to all measures, with the MUS group being more likely to report childhood and adulthood life events, more severe emotional dysregulation, traumatic stress and symptoms of anxiety and stress. Logistic regression analysis revealed that exposure to childhood traumatic life events, specifically childhood sexual abuse, and childhood physical neglect, were the only factors which were significantly associated with membership of the medically unexplained neurological symptoms group. Although further research is required to confirm our findings, our results suggest that identifying and addressing the impact of childhood trauma, may alleviate distress and aid recovery from functional neurological disorders.

摘要

尽管心理创伤与无法用医学解释的症状(MUS)之间的关系已得到充分证实,但在患有无法用医学解释的神经症状的人群中,这种关系的理解还不够深入。在本研究中,我们旨在比较功能性神经障碍和器质性神经障碍患者在童年和成年期创伤事件、创伤应激、情绪调节以及抑郁和焦虑症状方面的差异。我们假设,与器质性神经障碍患者相比,功能性神经障碍患者更有可能报告童年和成年期的创伤性生活事件、创伤症状、情绪失调以及焦虑和抑郁症状。研究样本由苏格兰一家医院连续招募的功能性神经障碍患者和器质性神经障碍患者(n=82)组成。参与者完成了生活事件、创伤应激、情绪调节、焦虑和抑郁的评估。结果发现,两组在所有测量指标上均存在显著差异,MUS 组更有可能报告童年和成年期的生活事件,情绪失调更严重,创伤应激和焦虑、压力症状更明显。逻辑回归分析显示,暴露于童年创伤性生活事件,特别是童年性虐待和童年身体忽视,是与无法用医学解释的神经症状组相关的唯一显著因素。尽管需要进一步的研究来证实我们的发现,但我们的结果表明,识别和处理童年创伤的影响,可能有助于减轻功能性神经障碍患者的痛苦并促进其康复。

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