Unit for Psychiatric Research, Psychiatry, Aalborg University Hospital, Aalborg, Denmark.
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Pediatr Res. 2020 Nov;88(5):796-803. doi: 10.1038/s41390-020-0945-z. Epub 2020 May 11.
Pediatric onset psychogenic nonepileptic seizures (PNES) is a highly disabling disorder and potentially misdiagnosed as epilepsy. Still, knowledge regarding PNES in children and adolescents is limited and data on both incidence and characteristics are scarce. This study investigated the incidence rate (IR) and clinical characteristics of pediatric onset PNES, including possible differences when having comorbid epilepsy.
A population-based study of children and adolescents aged 5-17 years with an incident diagnosis of PNES in the Danish healthcare registries between 1996 and 2014. In total, 386 children and adolescents were included after assessment of diagnostic validity using medical record data.
The IR increased during the study period with the maximum IR observed in 2014 (7.4 per 100,000 person-years). A history of both neurologic and psychiatric problems as well as negative life events was identified. Comorbid epilepsy was confirmed for 55 cases (14.2%) and was associated with intellectual disabilities, school support and prolonged delay in PNES diagnosis.
PNES are increasingly diagnosed in children and adolescents, and the clinical profile of both neurologic and psychiatric health problems underscores the need for collaborative pediatric and mental healthcare. These findings provide important information for future healthcare planning in this area.
This nationwide study is the first to report population-based incidence rates of pediatric onset PNES documenting markedly increasing incidence rates between 1996 and 2014. A history of both neurologic and psychiatric problems as well as negative life events was identified for pediatric onset PNES. Comorbid epileptic seizures were associated with intellectual disabilities, school support and prolonged delay in PNES diagnosis. The clinical profile of both neurologic and psychiatric health problems underscores the need for collaborative pediatric and mental healthcare. The increasing number of children and adolescents diagnosed with PNES is important information for future healthcare planning in this area.
儿科起病心因性非癫痫性发作（PNES）是一种高度致残性疾病，且可能被误诊为癫痫。尽管如此，儿童和青少年的 PNES 相关知识仍有限，发病率和特征方面的数据也很匮乏。本研究调查了儿科起病 PNES 的发病率（IR）和临床特征，包括合并癫痫时可能存在的差异。
对丹麦医疗保健登记处中 1996 年至 2014 年间诊断为儿科起病 PNES 的儿童和青少年进行了一项基于人群的研究。在使用病历数据评估诊断有效性后，共纳入 386 例儿童和青少年。
研究期间，IR 呈上升趋势，2014 年达到最高值（7.4/10 万人年）。研究确定了既往存在神经和精神问题以及负性生活事件的情况。55 例（14.2%）被确诊为合并癫痫，其与智力障碍、学校支持和 PNES 诊断的延迟时间延长相关。
PNES 在儿童和青少年中的诊断率不断上升，神经和精神健康问题的临床表现强调了开展儿科和精神科协作医疗保健的必要性。这些发现为该领域的未来医疗保健规划提供了重要信息。
本全国性研究首次报告了儿科起病 PNES 的基于人群的发病率，记录了 1996 年至 2014 年间发病率的显著上升。儿科起病 PNES 既往存在神经和精神问题以及负性生活事件。合并癫痫发作与智力障碍、学校支持和 PNES 诊断的延迟时间延长相关。神经和精神健康问题的临床表现强调了开展儿科和精神科协作医疗保健的必要性。越来越多的儿童和青少年被诊断为 PNES，这是该领域未来医疗保健规划的重要信息。
