Universidad de Buenos Aires (UBA), Instituto de Investigaciones, Facultad de Psicología, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), C1425FQB Buenos Aires, Argentina.
Universidad de Buenos Aires (UBA), Centro de Epilepsia, Hospital de Agudos "J. M. Ramos Mejía", C1221ADC Buenos Aires, Argentina.
Actas Esp Psiquiatr. 2024 Oct;52(5):616-624. doi: 10.62641/aep.v52i5.1707.
Functional/dissociative seizures (FDS), also known as psychogenic non-epileptic seizures (PNES), are sudden, transient, and involuntary events that include motor, sensory, cognitive or autonomic function alterations. In this work we analyzed the psychopathological characteristics of a subgroup of women who suffer from FDS with the aim to analyze the role of psychological trauma, with special emphasis on trauma due to sexual abuse (SA).
Forty-five women diagnosed with FDS were included in the study (age range 18 to 64 years, mean = 34.7, standard deviation (SD) = 13.1). Clinical and psychopathological characteristics were reviewed. All patients have completed the clinical interviews, the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID II) and the Global Assessment of Functioning (GAF) according to a special protocol for mental health assessment. Also, the history of sexual abuse trauma, the history of other non-sexual traumas and absence of history of trauma were reviewed.
Eighty percent of the cases reported a history of trauma, and 40% reported a history of SA. Patients with a history of SA presented a significantly lower average age of seizure onset than patients with a history of other non-sexual traumas (p = 0.021). Significant associations were found between SA and post-traumatic stress disorder (PTSD) (p = 0.031), and SA and history of suicide attempts (p = 0.037).
SA carries serious implications for the mental health of women suffering from FDS. Mental health professionals must consider the history of this type of trauma to provide the necessary care for this patient population.
功能性/分离性发作（FDS），也称为心因性非癫痫性发作（PNES），是突然、短暂和无意识的事件，包括运动、感觉、认知或自主功能改变。在这项工作中，我们分析了一组患有 FDS 的女性的精神病理学特征，目的是分析心理创伤的作用，特别强调性虐待（SA）引起的创伤。
共纳入 45 名被诊断为 FDS 的女性患者（年龄 18 至 64 岁，平均年龄 34.7，标准差 13.1）。回顾了临床和精神病理学特征。所有患者均根据心理健康评估的特殊方案完成了临床访谈、DSM-IV 轴 I 障碍的结构临床访谈（SCID-I）、DSM-IV 轴 II 人格障碍的结构临床访谈（SCID II）和全面功能评估（GAF）。还回顾了性虐待创伤史、其他非性创伤史和无创伤史。
80%的病例报告有创伤史，40%报告有性虐待史。有性虐待史的患者发病年龄明显低于有其他非性创伤史的患者（p=0.021）。性虐待与创伤后应激障碍（PTSD）（p=0.031）和性虐待与自杀未遂史（p=0.037）之间存在显著相关性。
SA 对患有 FDS 的女性的心理健康有严重影响。精神卫生专业人员必须考虑此类创伤的病史，为这一患者群体提供必要的护理。
