Sawant Neena S, Umate Maithili S
Dept. of Psychiatry, Seth GSMC & KEM Hospital, Mumbai, Maharashtra, India.
Dept. of Psychiatry, Grant Govt Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India.
Indian J Psychol Med. 2021 Nov;43(6):479-484. doi: 10.1177/0253717620956460. Epub 2020 Nov 2.
Psychogenic nonepileptic seizures (PNES) commonly present both to neurologists and psychiatrists and include a wide range of psychopathology. In order to understand the demographics, dissociative experiences, stressful life events, abuse, and coping in these patients, this study was undertaken.
This was a cross-sectional, observational study. A total of 71 patients of PNES, referred from neurology, were assessed on Dissociative Experience Scale (DES), Scale For Trauma and Abuse, Presumptive Stressful Life Events Scale (PSLES), and Ways of Coping Questionnaire to ascertain the dissociative experiences; the prevalence of trauma, abuse, and stressful life events, and the coping mechanisms.
Females predominated, with the duration of PNES up to 2 years. The mean ± SD total DES score was 38.14 ± 14.1, indicating high dissociation. On the PSLES, for the stressful life events in the last one year, the mean score was 98.28 ± 87.1. Marital and family conflicts and death were reported more. History of childhood or adult physical and sexual abuse was less reported. History of head trauma was present in 13 patients. Emotion-focused coping was used more than problem-solving strategies.
Very few Indian studies have looked into these nuances. This study has helped in improving the understanding of the various risk factors of PNES and the coping strategies, and in sensitizing psychiatrists and neurologists to enquire into trauma and abuse of these patients.
心理性非癫痫发作（PNES）常见于神经科医生和精神科医生处，涵盖广泛的精神病理学表现。为了解这些患者的人口统计学特征、分离体验、应激性生活事件、虐待情况及应对方式，开展了本研究。
这是一项横断面观察性研究。对71例从神经科转诊来的PNES患者进行解离体验量表（DES）、创伤与虐待量表、推定应激性生活事件量表（PSLES）及应对方式问卷评估，以确定解离体验、创伤、虐待及应激性生活事件的患病率以及应对机制。
女性占主导，PNES病程长达2年。DES总分的均值±标准差为38.14±14.1，表明解离程度高。在PSLES上，过去一年应激性生活事件的平均得分为98.28±87.1。婚姻和家庭冲突及死亡的报告更多。童年或成年期身体和性虐待的报告较少。13例患者有头部外伤史。情绪聚焦应对方式的使用多于问题解决策略。
很少有印度研究关注这些细微差别。本研究有助于增进对PNES各种危险因素及应对策略的理解，并促使精神科医生和神经科医生关注询问这些患者的创伤和虐待情况。
