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精神科医生对功能性神经障碍的态度:一项全国性调查的结果。

Psychiatrists' attitudes towards functional neurological disorders: results from a national survey.

作者信息

Marotta Angela, Lasalvia Antonio, Fiorio Mirta, Zanalda Enrico, Di Sciascio Guido, Palumbo Claudia, Papola Davide, Barbui Corrado, Tinazzi Michele

机构信息

Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.

Department of Mental Health ASL TO3 and AOU San Luigi Gonzaga, Collegno, Italy.

出版信息

Front Psychiatry. 2023 Jul 14;14:1216756. doi: 10.3389/fpsyt.2023.1216756. eCollection 2023.

Abstract

INTRODUCTION

Functional neurological disorder (FND) presents motor, sensory, and cognitive symptoms characterized by clinical signs incongruent with known neurological disease. Together with other health professionals, like neurologists, psychiatrists can play an essential role in diagnosing and managing these disorders. Hence, understanding their opinion and clinical experience with FND is of utmost importance to catch potential educational needs and improve healthcare services for patients. This study aims at assessing the knowledge, opinion, and clinical approach of Italian psychiatrists to FND.

METHODS

Members of the Italian Society of Psychiatry completed a 14-item web-based survey investigating their approach to FND. Results. Overall, 174 questionnaires were completed. Our main findings suggest that Italian psychiatrists have a psychogenetic conceptualization of FND. "Conversion disorders", in fact, is the term most frequently used by Italian psychiatrists to refer to FND, thus implying a psychological etiology of these disorders. Congruently with this view, psychotherapy associated with pharmacological therapy is considered the most appropriate treatment by psychiatrists, while physiotherapy is an under-recognized treatment option for FND.

DISCUSSION

The present study highlights that a psychogenetic view of FND dominates among Italian psychiatrists. This could be due to out-of-date knowledge about the pathophysiology of this group of disorders. Promoting education about novel approaches to FND would be of crucial importance to improving care for patients suffering from this condition.

摘要

引言

功能性神经障碍(FND)表现出运动、感觉和认知症状,其临床体征与已知神经疾病不一致。与其他医疗专业人员(如神经科医生)一样,精神科医生在诊断和管理这些疾病方面可发挥重要作用。因此,了解他们对FND的看法和临床经验对于发现潜在的教育需求以及改善患者的医疗服务至关重要。本研究旨在评估意大利精神科医生对FND的知识、看法和临床方法。

方法

意大利精神病学会的成员完成了一项基于网络的14项调查,调查他们对FND的处理方法。结果。总体而言,共完成了174份问卷。我们的主要研究结果表明,意大利精神科医生对FND有心理遗传学的概念。事实上,“转换障碍”是意大利精神科医生最常用来指代FND的术语,这意味着这些疾病的心理病因。与此观点一致,精神科医生认为心理治疗联合药物治疗是最合适的治疗方法,而物理治疗是FND一种未得到充分认可的治疗选择。

讨论

本研究强调,FND的心理遗传学观点在意大利精神科医生中占主导地位。这可能是由于对这组疾病病理生理学的知识过时。促进对FND新方法的教育对于改善对患有这种疾病的患者的护理至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4272/10375048/938591579879/fpsyt-14-1216756-g001.jpg

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