Scheidt C E, Köster B, Deuschl G
Abteilung Psychotherapie und Psychosomatische Medizin, Albert-Ludwigs-Universität Freiburg.
Nervenarzt. 1996 Mar;67(3):198-204.
A total of 21 patients with psychogenic tremor (PT) were asked to take part in a neurologic and psychosomatic assessment; for 17 patients follow-up information was also recorded. Women out-numbered men in the sample. In the majority of patients the tremor was associated with a variety of other conversion symptoms. The clinical picture of the tremor varied. After beginning exclusively in the extremities, it tended to spread to other parts of the body. Other psychopathology (depression and histrionic personality disorder) existed in almost a third of the sample. Many patients had retired from professional life, or planned to do so in the near future, because of PT. At follow up the initial diagnosis was confirmed in all patients although in some patients additional physical illness had developed during the follow-up period. When neurological and psychiatric/psychosomatic criteria are applied the diagnosis of PT can be established reliably. Studies that have questioned the validity of the conversion concept on the basis of frequent misdiagnoses may indicate problems in the diagnostic procedure rather than an invalid theoretical construct.
共有21名心因性震颤(PT)患者被要求参与神经学和身心评估;还记录了17名患者的随访信息。样本中女性多于男性。大多数患者的震颤与多种其他转换症状相关。震颤的临床表现各不相同。最初仅出现在四肢,之后倾向于蔓延至身体其他部位。近三分之一的样本存在其他精神病理学问题(抑郁和表演型人格障碍)。许多患者因心因性震颤已从职业生活中退休,或计划在不久的将来退休。随访时,所有患者的初始诊断均得到证实,尽管部分患者在随访期间出现了其他躯体疾病。当应用神经学和精神科/身心标准时,心因性震颤的诊断可以可靠地确立。那些基于频繁误诊而质疑转换概念有效性的研究,可能表明诊断过程存在问题,而非理论构建无效。