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眼动脱敏再处理治疗功能性神经症状障碍伴心因性非癫痫性发作:两例研究。

Eye movement desensitization and reprocessing treatment in functional neurological symptom disorder with psychogenic nonepileptic seizures: A study of two cases.

机构信息

Department of Psychology, 270726Istanbul Gelisim University, Istanbul, Turkey.

Department of Psychiatry, 162307Bagcilar Training and Research Hospital, Istanbul, Turkey.

出版信息

Clin Child Psychol Psychiatry. 2021 Oct;26(4):1196-1207. doi: 10.1177/13591045211037276. Epub 2021 Aug 5.

Abstract

Patients with functional neurological symptom disorder (FND) have many diverse symptoms including psychogenic nonepileptic seizures (PNES), positive movements such as tremor, dystonia, or gait abnormalities, loss of motor function such as leg or arm paresis, and loss of sensory functions, such as blindness, deafness, or loss of feeling in the limbs. Eye movement desensitization and reprocessing (EMDR) is a therapy method that includes some techniques arising from psychodynamic, cognitive, and behavioral approaches. EMDR is known as a proven psychotherapeutic approach in post-traumatic stress disorder, but there are also numerous studies reporting its efficacy in other psychiatric disorders and trauma-associated symptoms, in patients with comorbid psychiatric disorders. This article presents the outcome of EMDR treatment of two patients' cases, a 13-year-old female and a 16-year-old male, who were diagnosed as FND with PNES, according to the DSM-5 diagnostic criteria. In both cases, there was a significant decrease in Adolescent Dissociative Experiences Scale scores and no pseudo seizures were found, even at the sixth-month follow-up visits. These case studies suggest that EMDR can be an effective method in the long-term treatment of FND with PNES and a useful alternative to other treatment methods.

摘要

患有功能性神经症状障碍(FND)的患者有许多不同的症状,包括心因性非癫痫性发作(PNES)、阳性运动如震颤、肌张力障碍或步态异常、运动功能丧失如腿部或手臂瘫痪以及感觉功能丧失,如失明、耳聋或四肢失去知觉。眼动脱敏再处理(EMDR)是一种治疗方法,包括一些源自心理动力学、认知和行为方法的技术。EMDR 被认为是创伤后应激障碍的一种经过验证的心理治疗方法,但也有许多研究报告称,它在其他精神障碍和与创伤相关的症状中,以及在合并精神障碍的患者中,也具有疗效。本文介绍了根据 DSM-5 诊断标准诊断为 FND 伴 PNES 的两名患者的 EMDR 治疗结果,这两名患者分别为 13 岁的女性和 16 岁的男性。在这两种情况下,青少年分离体验量表的评分都有显著下降,甚至在第六个月的随访中也没有发现假性发作。这些案例研究表明,EMDR 可能是 FND 伴 PNES 的长期有效治疗方法,也是其他治疗方法的有用替代方法。

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