Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China.
Academic Neurology Unit, University of Sheffield, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, United Kingdom.
Seizure. 2018 Mar;56:78-87. doi: 10.1016/j.seizure.2018.01.017. Epub 2018 Jan 31.
This study is intended to provide an overview of diagnostic and treatment services for patients with psychogenic nonepileptic seizures (PNES) across China.
Using a questionnaire devised by the PNES Task Force of Neuropsychiatry Commission of the International League Against Epilepsy (ILAE), we conducted a survey among Chinese health professionals at the Sixth Advanced International Course: Clinical Epileptology. Descriptive analyses were performed.
Responses from 102 eligible clinicians were analysed. Responses were received from urban areas in 20 provinces/municipalities around China. Most respondents were neurologists. The results showed that hospitals in urban China were mostly well-equipped, and that health professionals' understanding of PNES largely reflected current international expert opinion. However, many of the participants would not actually make the diagnosis, and most provided neither follow-up nor treatment (especially psychotherapy) for patients with PNES. Only about one third of the patients diagnosed with PNES were estimated to receive at least one appointment for psychological treatment. In the opinion of the respondents, tacit trauma (neglect and stress) play an important role in the development of PNES. The main obstacles to patients with PNES accessing health services for their condition were thought to be lack of knowledge or awareness among health professionals, patients and society.
Despite good access to equipment, diagnostic and treatment services for patients with PNES in China are currently deficient. Education programs about PNES with different target groups, and more effective referral and social security systems emerge as particular development needs from this survey.
本研究旨在概述中国针对心因性非癫痫性发作（PNES）患者的诊断和治疗服务。
我们使用神经精神病学委员会国际抗癫痫联盟（ILAE）PNES 工作组设计的问卷，在中国第六届高级国际临床癫痫学课程上对中国卫生专业人员进行了调查。进行了描述性分析。
对 102 名合格临床医生的回复进行了分析。回复来自中国 20 个省/市的城市地区。大多数受访者是神经科医生。结果表明，中国城市的医院设备大都精良，卫生专业人员对 PNES 的认识在很大程度上反映了当前的国际专家意见。然而，许多参与者实际上不会做出诊断，并且大多数人既不提供随访，也不提供（尤其是心理治疗）PNES 患者的治疗。只有大约三分之一的被诊断为 PNES 的患者被估计会接受至少一次心理治疗预约。根据受访者的意见，隐性创伤（忽视和压力）在 PNES 的发展中起着重要作用。卫生专业人员、患者和社会对 PNES 缺乏了解或认识，被认为是 PNES 患者获得医疗服务的主要障碍。
尽管设备的获取情况良好，但中国针对 PNES 患者的诊断和治疗服务目前仍存在不足。针对不同目标群体的 PNES 教育计划，以及更有效的转诊和社会保障系统，是本调查中出现的特定发展需求。
