Srinath S, Bharat S, Girimaji S, Seshadri S
Child and Adolescent Psychiatry Services.
J Am Acad Child Adolesc Psychiatry. 1993 Jul;32(4):822-5. doi: 10.1097/00004583-199307000-00017.
This study examined the rate, correlates, and clinical outcome of childhood hysteria in a sample of inpatients in India. For comparison, the rate of this disorder among outpatients was computed.
Data were derived from case records of inpatient (n = 143) and outpatient admissions (n = 640) during a 1-year interval at the Child and Adolescent Psychiatry Unit of the National Institute of Mental Health and Neurosciences, Bangalore, South India.
The diagnosis of hysteria was made in 30.8% (n = 44) of the inpatient and 14.8% (n = 95) of the outpatient samples. The inpatients with hysteria were mostly postpubertal, their gender distribution was approximately even, and pseudo-seizure was the most frequent presentation. These inpatients had a brief duration of illness at admission and short-term outcome was generally positive.
Children with hysterical symptoms form a notable proportion of cases in child guidance and psychiatry clinics in India. It could be that, in this culture, having a "medical" illness is one of the more acceptable means of seeking psychiatric help. The use of a structured and intensive inpatient treatment package appeared to bring about rapid symptom remission. Some of the present findings could be the basis to explore subtypes of childhood hysteria.
本研究调查了印度住院儿童样本中癔症的发病率、相关因素及临床结局。为作比较,还计算了门诊患者中该疾病的发病率。
数据来源于印度南部班加罗尔国家心理健康和神经科学研究所儿童与青少年精神病科在1年时间内的住院患者(n = 143)和门诊患者(n = 640)的病例记录。
住院患者样本中30.8%(n = 44)被诊断为癔症,门诊患者样本中这一比例为14.8%(n = 95)。患癔症的住院患者大多处于青春期后,其性别分布大致均匀,假性癫痫是最常见的表现形式。这些住院患者入院时病程较短,短期预后总体良好。
在印度的儿童指导和精神病诊所中,有癔症症状的儿童占相当比例。可能在这种文化中,患有“躯体”疾病是寻求精神科帮助的较易被接受的方式之一。采用结构化的强化住院治疗方案似乎能使症状迅速缓解。目前的一些研究结果可为探索儿童癔症的亚型提供依据。