Gargiulo Ángel Jm, Sarudiansky Mercedes, Videla Alejandro, Lombardi Nicolás, Korman Guido P, Oddo Silvia, D Alessio Luciana
Universidad de Buenos Aires (UBA), Facultad de Medicina, IBCN (Instituto de Biología Celular y Neurociencias)-CONICET, Argentina; Centro de Epilepsia del Hospital El Cruce, Estudios en Neurociencias y Sistemas Complejos (ENyS), Argentina; Universidad de Buenos Aires (UBA), Facultad de Medicina, Centro de Epilepsia del Hospital Ramos Mejía.
Universidad de Buenos Aires (UBA), Facultad de Psicología- CONICET, Buenos Aires, Argentina.
Seizure. 2022 Oct;101:141-148. doi: 10.1016/j.seizure.2022.08.002. Epub 2022 Aug 11.
Depression and anxiety are psychiatric disorders related to chronic stress, commonly found in patients with drug-resistant epilepsy (DRE) and functional dissociative seizures (FDS). The present study compares the levels of perceived stress, resilience, and the styles of stress coping among patients with DRE (n=60), FDS (n=28), and controls (n=31).
We performed a cross-sectional study. All patients underwent Video Electroencephalography to confirm the diagnosis and completed the psychiatric assessment (SCID I and II of DSM IV) supported by several instruments validated in Spanish.
FDS scored higher in perceived stress (p = 0.004) with lower levels of resilience compared to controls (p = 0.01). Stress coping subscales show higher scores in negative self-focus and hostility in patients with FDS compared to controls (p=0.003). Similarly, DRE patients scored higher in perceived stress (p = 0.001), and presented lower levels of resilience (p = 0.004) with higher levels of hostility compared to controls (p=0.02). However, no significant differences were found between FDS and DRE on stress coping variables. Anxiety scores and depression rates were higher in the FDS group compared to DRE (p=0.008) and higher in DRE compared to controls (p<0.05). A positive correlation between depression and perceived stress was found (r = 0.6, p=0.0001).
Our results delineate a more detailed picture of the psychological profile of this population, emphasizing the importance of stress factors in patients with FDS and DRE. Combined intervention strategies which enhance stress coping may be appropriate to direct treatment and psychotherapy.
抑郁和焦虑是与慢性应激相关的精神障碍，常见于耐药性癫痫（DRE）和功能性分离性癫痫发作（FDS）患者。本研究比较了DRE患者（n = 60）、FDS患者（n = 28）和对照组（n = 31）的感知压力水平、心理韧性以及压力应对方式。
我们进行了一项横断面研究。所有患者均接受视频脑电图检查以确诊，并完成了由几种经西班牙语验证的工具支持的精神评估（DSM-IV的SCID I和II）。
与对照组相比，FDS在感知压力方面得分更高（p = 0.004），心理韧性水平更低（p = 0.01）。与对照组相比，FDS患者在压力应对分量表上的负面自我关注和敌意得分更高（p = 0.003）。同样，与对照组相比，DRE患者在感知压力方面得分更高（p = 0.001），心理韧性水平更低（p = 0.004），敌意水平更高（p = 0.02）。然而，FDS和DRE在压力应对变量上未发现显著差异。FDS组的焦虑得分和抑郁率高于DRE组（p = 0.008），DRE组高于对照组（p < 0.05）。发现抑郁与感知压力之间存在正相关（r = 0.6，p = 0.0001）。
我们的结果描绘了这一人群心理特征的更详细情况，强调了压力因素在FDS和DRE患者中的重要性。增强压力应对的联合干预策略可能适合指导治疗和心理治疗。
