Lang T, Eich D
Abteilung für Psychosoziale Medizin, Psychiatrische Poliklinik, Universitätsspital Zürich.
Schweiz Med Wochenschr. 1994 Jul 2;124(26):1162-8.
Psychogenic loss of consciousness often leads to clinical situations where making decisions is difficult and psychiatric consultation becomes necessary. The function of the consultation/liaison-psychiatrist consists in rendering information from the psychosocial context comprehensible after establishing a first contact with the patient and his family and after the first psychiatric assessment. In a second step, the CL-psychiatrist then may make further recommendations how to deal with the patient, possibly not only in a patient-centered, but also team-centered manner. This article demonstrates a possible approach and differential diagnosis in the light of two clinical case reports. The theoretical part defines and classifies psychogenic loss of consciousness. It then deals with disorders of consciousness in epilepsy and the psychodynamics of psychogenic seizures as a subconscious expression of unbearable or unsolvable conflicts.
心因性意识丧失常常导致临床中决策困难且有必要进行精神科会诊的情况。会诊联络精神科医生的职责在于，在与患者及其家属首次接触并完成首次精神科评估后，使来自社会心理背景的信息变得易于理解。第二步，会诊联络精神科医生随后可能会就如何治疗患者提出进一步建议，可能不仅是以患者为中心，也会以团队为中心。本文根据两份临床病例报告展示了一种可能的方法和鉴别诊断。理论部分对心因性意识丧失进行了定义和分类。接着探讨了癫痫中的意识障碍以及心因性发作的心理动力学，将其作为无法承受或无法解决的冲突的潜意识表达。
