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心理性非癫痫性发作患者精神共病与发作症状学之间关系的评估。

Evaluation of the relationships between psychiatric comorbidity and seizure semiology in psychogenic non-epileptic seizure patients.

作者信息

Yılmaz Gülce Coşku, Türe Hatice Sabiha, Kılıçaslan Esin Evren, Akhan Galip

机构信息

İzmir University of Economics Medical Point Hospital, Department of Neurology, Yeni Girne, 35575 Karşıyaka, İzmir, Turkey.

İzmir Katip Çelebi University Atatürk Research and Training Hospital, Department of Neurology, Basınsitesi, 35150 Karabağlar, İzmir, Turkey.

出版信息

Acta Psychol (Amst). 2025 Feb;252:104672. doi: 10.1016/j.actpsy.2024.104672. Epub 2024 Dec 18.

Abstract

Psychogenic non-epileptic seizures (PNES) are episodic events that bear a resemblance to epileptic seizures (ES) in their outward manifestations, yet they lack pathological electroencephalographic (EEG) activity during the ictal phase. In the Diagnostic and Statistical Manual 5th Edition (DSM-5), PNES is designated as "Functional Neurological Symptom Disorder with seizures". Individuals diagnosed with PNES commonly present with concurrent psychiatric disorders, notably depression, panic disorder, and chronic anxiety. This phenomenon renders PNES a shared affliction within the domains of neurology and psychiatry, thereby mandating the implementation of diverse therapeutic approaches in the management of the condition. Indeed, identifying the presence of concurrent psychiatric disorders in a patient with PNES during the early stages is crucial for devising an appropriate treatment plan. In this study, an assessment was conducted to examine the correlation between PNES semiology and psychiatric disorder comorbidity, to elucidate whether semiological characteristics serve as predictors for the presence of comorbid psychiatric disorders. The PNES patients enrolled were divided into two subgroups based on the presence or absence of accompanying psychiatric disorders (onlyPNES and PNES+). The study assessed disparities in semiological characteristics between the two subgroups of PNES and the results obtained indicate that individual variations in semiotic features are not influenced by the presence of psychiatric comorbidity.

摘要

心理性非癫痫发作(PNES)是一种发作性事件,其外在表现与癫痫发作(ES)相似,但在发作期缺乏病理性脑电图(EEG)活动。在《精神疾病诊断与统计手册》第5版(DSM-5)中,PNES被指定为“伴有癫痫发作的功能性神经症状障碍”。被诊断为PNES的个体通常同时患有精神疾病,尤其是抑郁症、惊恐障碍和慢性焦虑症。这种现象使PNES成为神经病学和精神病学领域的共同困扰,因此在该疾病的管理中需要采用多种治疗方法。事实上,在早期识别PNES患者中同时存在的精神疾病对于制定合适的治疗计划至关重要。在本研究中,进行了一项评估,以检查PNES症状学与精神疾病共病之间的相关性,以阐明症状学特征是否可作为共病精神疾病存在的预测指标。根据是否伴有精神疾病将纳入的PNES患者分为两个亚组(仅PNES组和PNES+组)。该研究评估了PNES两个亚组之间症状学特征的差异,所得结果表明符号学特征的个体差异不受精神疾病共病的影响。

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