Kletenik Isaiah, Sillau Stefan H, Isfahani Sanaz Attaripour, LaFaver Kathrin, Hallett Mark, Berman Brian D
Department of Neurology University of Colorado School of Medicine Aurora Colorado USA.
Behavioral Neurology Section University of Colorado School of Medicine Aurora Colorado USA.
Mov Disord Clin Pract. 2019 Dec 13;7(2):177-181. doi: 10.1002/mdc3.12863. eCollection 2020 Feb.
The prevalence of functional movement disorders is 2 to 3 times higher in women than in men. Trauma and adverse life events are important risk factors for developing functional movement disorders. On a population level, rates of sexual abuse against women are higher when compared with the rates against men.
To determine gender differences in rates of sexual abuse in functional movement disorders compared with other neurologic disorders and evaluate if the gender prevalence is influenced by higher rates of sexual abuse against women.
We performed a case-control series including 199 patients with functional movement disorders (149 women) and 95 controls (60 women). We employed chi-squared test to assess gender and sexual abuse associations and Bayes formula to condition on sexual abuse.
Our analysis showed an association between sexual abuse and functional movement disorders in women (odds ratio, 4.821; 95% confidence interval, 2.089-12.070; < 0.0001), but not men. Bayesian analysis found the functional movement disorder prevalence ratio between women and men conditional on sexual abuse to be 4.87 times the unconditioned ratio.
There is a statistically significant association between sexual abuse and functional movement disorders in women and a greater likelihood that women who are sexually abused will develop functional movement disorders than men who are sexually abused. Our findings suggest that the increased prevalence of functional movement disorders in women is associated, at least in part, with sexual abuse and its sequelae; however, further research is needed to explore the role of other traumatic and nontraumatic factors.
功能性运动障碍在女性中的患病率比男性高2至3倍。创伤和不良生活事件是引发功能性运动障碍的重要风险因素。在总体人群中，女性遭受性虐待的比例高于男性。
确定与其他神经系统疾病相比，功能性运动障碍中性虐待发生率的性别差异，并评估女性较高的性虐待发生率是否会影响性别患病率。
我们进行了一项病例对照研究，纳入199例功能性运动障碍患者（149名女性）和95名对照者（60名女性）。我们采用卡方检验来评估性别与性虐待之间的关联，并使用贝叶斯公式来分析性虐待情况。
我们的分析显示，性虐待与女性功能性运动障碍之间存在关联（优势比，4.821；95%置信区间，2.089 - 12.070；P < 0.0001），但在男性中不存在这种关联。贝叶斯分析发现，在考虑性虐待因素的情况下，女性与男性功能性运动障碍患病率之比是未考虑该因素时的4.87倍。
性虐待与女性功能性运动障碍之间存在统计学上的显著关联，遭受性虐待的女性比遭受性虐待的男性更有可能患上功能性运动障碍。我们的研究结果表明，女性功能性运动障碍患病率的增加至少部分与性虐待及其后遗症有关；然而，需要进一步研究来探讨其他创伤性和非创伤性因素的作用。
