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功能性癫痫患者的人格障碍：一项系统评价

Personality disorders in individuals with functional seizures: a systematic review.

作者信息

Sammarra Ilaria, Martino Iolanda, Marino Laura, Fortunato Francesco, Gambardella Antonio

机构信息

Institute of Neurology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy.

出版信息

Front Psychiatry. 2024 Aug 1;15:1411189. doi: 10.3389/fpsyt.2024.1411189. eCollection 2024.

DOI:10.3389/fpsyt.2024.1411189
PMID:39165499
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11333798/
Abstract

UNLABELLED

Functional seizures (FS) are classified as conversion disorders in the DSM-5 and dissociative disorders in the ICD-11, showing a multifactorial psychopathology with various psychiatric comorbidities, such as depression and anxiety. Several studies have found a correlation between FS and personality disorders, mainly those in cluster B. Within this cluster, borderline personality disorder (BPD) or borderline personality traits are the most prevalent in FS. Emotion dysregulation is a hallmark of BPD and is commonly reported in individuals with FS. Cluster C personality disorders, such as avoidant or obsessive-compulsive disorders, have also been reported in FS. In this review, we aim to evaluate the relationship between FS and personality disorders. Assessing personality disorders in the context of FS is relevant for determining the most appropriate intervention. Cognitive-behavioral therapy (CBT) is considered the first-line approach to treating FS. Among various CBT strategies, dialectical behavior therapy, which specifically targets emotion dysregulation, may be helpful for individuals with BPD. Future research should assess the advantages of systematically evaluating personality disorders in FS to address specific treatment planning and evaluate its effectiveness on seizure recurrence, psychological comorbidities, and quality of life.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/PROSPEROFILES/509286_STRATEGY_20240203.pdf, identifier CRD42024509286.

摘要

未标注

功能性癫痫发作（FS）在《精神疾病诊断与统计手册》第5版中被归类为转换障碍，在《国际疾病分类》第11版中被归类为分离障碍，表现出具有多种精神共病（如抑郁和焦虑）的多因素精神病理学特征。多项研究发现FS与人格障碍之间存在关联，主要是B类人格障碍。在这一类别中，边缘型人格障碍（BPD）或边缘型人格特质在FS中最为普遍。情绪调节障碍是BPD的一个标志，在FS患者中也经常有报告。C类人格障碍，如回避型或强迫型障碍，在FS中也有报告。在本综述中，我们旨在评估FS与人格障碍之间的关系。在FS的背景下评估人格障碍对于确定最合适的干预措施具有重要意义。认知行为疗法（CBT）被认为是治疗FS的一线方法。在各种CBT策略中，专门针对情绪调节障碍的辩证行为疗法可能对BPD患者有帮助。未来的研究应评估系统评估FS中人格障碍以制定具体治疗计划的优势，并评估其对癫痫复发、心理共病和生活质量的有效性。

系统评价注册

https://www.crd.york.ac.uk/PROSPEROFILES/509286_STRATEGY_20240203.pdf，标识符CRD42024509286。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/31a9/11333798/ab456a4f447e/fpsyt-15-1411189-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/31a9/11333798/f5cd9e541b6f/fpsyt-15-1411189-g001.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/31a9/11333798/f5cd9e541b6f/fpsyt-15-1411189-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/31a9/11333798/89bd370bbecc/fpsyt-15-1411189-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/31a9/11333798/fd3470d3bc95/fpsyt-15-1411189-g003.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/31a9/11333798/ab456a4f447e/fpsyt-15-1411189-g005.jpg

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本文引用的文献

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Depression, anxiety, stress, and suicide risk in patients with functional seizures vs. those with epilepsy.功能性发作与癫痫患者的抑郁、焦虑、压力和自杀风险。
Acta Neurol Belg. 2024 Feb;124(1):169-173. doi: 10.1007/s13760-023-02365-0. Epub 2023 Aug 29.
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Borderline Personality Disorder: A Review.边缘型人格障碍：综述。
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The PRISMA 2020 statement: an updated guideline for reporting systematic reviews.PRISMA 2020 声明：系统评价报告的更新指南。
BMJ. 2021 Mar 29;372:n71. doi: 10.1136/bmj.n71.
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Psychiatric comorbidities in patients with psychogenic nonepileptic seizures.精神心因性非癫痫性发作患者的精神共病。
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