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心理社会应激因素触发的早发型转换障碍性步态失用症 1 例报告

A Case of Astasia-Abasia as Early Onset Conversion Disorder Triggered by Psychosocial Stress Factors.

出版信息

Turk Psikiyatri Derg. 2022 Spring;33(1):65-68. doi: 10.5080/u25272.

Abstract

Conversion disorder is defined as the loss or change of motor, sensory, and autonomic nervous system-related functions that cannot be explained completely with organic causes. The etiology of the disease may be explained by psychoanalytic theory, learning theory, sociocultural factors, and some traumatic life events besides genetic and neurobiological factors. The onset is usually between late childhood and early adulthood. The disorder occurs after a high rate of psychosocial stressors and the symptoms can vary. While astasia, as one of the possible complaints in conversion disorder, is defined as not being able to stand due to loss of motor power or sensory loss; abasia is identified as patients having no apparent motor problem but not being able to walk properly. Both conditions can be of organic as well as the psychogenic origin. In this paper, the clinical signs of a seven-year-old boy who was admitted to emergency service of Mersin University Faculty of Medicine with the complaints of astasia and abasia but was found to have conversion disorder is presented. The results of the medical examinations and the possible psychosocial stress factors behind these symptoms, as well as the treatment process of the case, were shared. With this report, we is aimed to draw attention to the importance of early diagnosis of the disorder, the necessity of an interdisciplinary approach in the treatment process, and the handling of psychosocial factors leading to somatic symptoms.

摘要

转换障碍定义为运动、感觉和自主神经系统相关功能的丧失或改变,这些功能不能完全用器质性原因来解释。除了遗传和神经生物学因素外,该疾病的病因可能可以用精神分析理论、学习理论、社会文化因素和一些创伤性生活事件来解释。发病通常在儿童晚期到成年早期之间。这种障碍通常发生在高心理社会压力源之后,症状可能会有所不同。虽然运动不能症,作为转换障碍的可能投诉之一,被定义为由于运动力量丧失或感觉丧失而无法站立;但是失用症被确定为患者没有明显的运动问题,但无法正常行走。这两种情况都可能是器质性的,也可能是心因性的。本文报告了一名 7 岁男孩的临床症状,该男孩因运动不能症和失用症入住梅斯大学医学院急诊部,但被诊断为转换障碍。本文介绍了该病例的体格检查结果和这些症状背后可能的心理社会压力因素,以及病例的治疗过程。通过本报告,我们旨在引起人们对该疾病早期诊断的重要性、治疗过程中多学科方法的必要性以及导致躯体症状的心理社会因素的处理的重视。

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