Department of Psychiatry, Alexandria University School of Medicine, Egypt.
Department of Neurology, Alexandria University School of Medicine, Egypt.
Epilepsy Behav. 2021 May;118:107918. doi: 10.1016/j.yebeh.2021.107918. Epub 2021 Mar 15.
Psychogenic nonepileptic seizures (PNES) are major challenges for diagnosis and management. The heterogeneity of psychogenic seizures is attributed to diverse psychopathological comorbidities, and the causal relationship between PNES and underlying psychopathologies is still enigmatic.
Our objective was to study psychiatric comorbidities and personality constructs in patients with PNES and compare them to a control group of patients with epilepsy.
We randomly recruited 33 patients with PNES and 33 patients with epilepsy. All patients completed the Mini-International Neuropsychiatric Interview (MINI) to screen for psychiatric comorbidities, the Structured Clinical Interview for psychiatric disorders in Axis II (SCID II) to screen for personality disorders, and Goldberg's International Personality Item Pool (IPIP) Big Five personality questionnaire to study the psychological constructs of extroversion-introversion, agreeableness, conscientiousness, emotional stability-neuroticism, and intellect.
Mood and anxiety disorders were highly prevalent in patients with PNES (72.7% and 54.5%, respectively); however, the prevalence of only cluster B personality disorder was higher in patients with PNES (69.7%) compared to 33.3% among patients with epilepsy (p < 0.05). Screening for personality disorders using SCID II showed that the prevalence of borderline and depressive personality disorders was significantly higher in patients with PNES (p < 0.001). Patients with psychogenic seizures were more likely to be receiving polydrug therapy (75.8%) compared to patients with epileptic seizures (45.5%); this difference was statistically significant (p < 0.05).
Psychiatric comorbidities are highly prevalent among patients with PNES.
心因性非癫痫性发作（PNES）是诊断和治疗的主要挑战。心因性发作的异质性归因于多种精神病理学共病，PNES 与潜在精神病理学之间的因果关系仍然扑朔迷离。
我们的目的是研究 PNES 患者的精神共病和人格结构，并将其与癫痫患者的对照组进行比较。
我们随机招募了 33 例 PNES 患者和 33 例癫痫患者。所有患者均完成了 Mini-International Neuropsychiatric Interview（MINI）以筛查精神共病，Structured Clinical Interview for psychiatric disorders in Axis II（SCID II）以筛查人格障碍，以及 Goldberg 的 International Personality Item Pool（IPIP）Big Five 人格问卷，以研究外向-内向、宜人性、尽责性、情绪稳定性-神经质和智力等心理结构。
心境和焦虑障碍在 PNES 患者中患病率很高（分别为 72.7%和 54.5%）；然而，仅 B 群人格障碍的患病率在 PNES 患者中更高（69.7%），而癫痫患者中为 33.3%（p<0.05）。使用 SCID II 筛查人格障碍显示，PNES 患者的边缘型和抑郁型人格障碍患病率明显更高（p<0.001）。与癫痫发作患者（45.5%）相比，PNES 患者更有可能接受多药治疗（75.8%）；这一差异具有统计学意义（p<0.05）。
PNES 患者的精神共病患病率很高。
