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在大型英国精神卫生服务机构中运动功能神经障碍患者的特征:一项病例对照研究。

Characteristics of patients with motor functional neurological disorder in a large UK mental health service: a case-control study.

机构信息

Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

出版信息

Psychol Med. 2020 Feb;50(3):446-455. doi: 10.1017/S0033291719000266. Epub 2019 Feb 18.

Abstract

BACKGROUND

Functional neurological disorder (FND), previously known as conversion disorder, is common and often results in substantial distress and disability. Previous research lacks large sample sizes and clinical surveys are most commonly derived from neurological settings, limiting our understanding of the disorder and its associations in other contexts. We sought to address this by analysing a large anonymised electronic psychiatric health record dataset.

METHODS

Data were obtained from 322 patients in the South London and Maudsley NHS Foundation Trust (SLaM) who had an ICD-10 diagnosis of motor FND (mFND) (limb weakness or disorders of movement or gait) between 1 January 2006 and 31 December 2016. Data were collected on a range of socio-demographic and clinical factors and compared to 644 psychiatric control patients from the same register.

RESULTS

Weakness was the most commonly occurring functional symptom. mFND patients were more likely to be female, British, married, employed pre-morbidly, to have a carer and a physical health condition, but less likely to have had an inpatient psychiatric admission or to receive benefits. No differences in self-reported sexual or physical abuse rates were observed between groups, although mFND patients were more likely to experience life events linked to inter-personal difficulties.

CONCLUSIONS

mFND patients have distinct demographic characteristics compared with psychiatric controls. Experiences of abuse appear to be equally prevalent across psychiatric patient groups. This study establishes the socio-demographic and life experience profile of this understudied patient group and may be used to guide future therapeutic interventions designed specifically for mFND.

摘要

背景

功能性神经障碍(FND),以前称为转换障碍,较为常见,常导致严重的痛苦和残疾。既往研究缺乏大样本量,且临床调查大多来自神经科环境,限制了我们对该疾病及其在其他环境中的关联的理解。我们试图通过分析一个大型匿名电子精神健康记录数据集来解决这个问题。

方法

该研究的数据来自 2006 年 1 月 1 日至 2016 年 12 月 31 日期间,在南伦敦和莫兹利国民保健信托基金会(SLaM)的 322 名患者,他们的 ICD-10 诊断为运动 FND(mFND)(肢体无力或运动或步态障碍)。收集了一系列社会人口统计学和临床因素的数据,并与来自同一登记处的 644 名精神科对照患者进行了比较。

结果

无力是最常见的功能性症状。mFND 患者更可能是女性、英国籍、已婚、有工作、有照顾者和身体疾病,但更不可能有住院精神科入院或领取福利。两组之间在自我报告的性或身体虐待率方面没有差异,尽管 mFND 患者更有可能经历与人际困难有关的生活事件。

结论

mFND 患者与精神科对照患者相比具有明显的人口统计学特征。在精神科患者群体中,虐待的经历似乎同样普遍。这项研究建立了这个研究不足的患者群体的社会人口统计学和生活经历概况,并可用于指导专门针对 mFND 的未来治疗干预措施。

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