心因性非痫性发作的精神相关长期预后_Journal of Epilepsy

Authors：

 KatrinWalther , BastianVolbers , LauraErdmann , 林岷涛　译 , 慕洁　审

Corresponding author：

KatrinWalther, Email: katrin.walther@uk-erlangen.de

Keywords：

生活质量; 长期预后; 人格; 心因性非痫性发作; 精神病理学

DOI：

10.7507/2096-0247.20200074

Video：

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探讨心因性非癫痫性癫痫发作（Psychogenic nonepileptic seizures，PNES）患者的长期心理状态、人格和健康相关生活质量（Health-related quality of life，HRQoL），并确定 PNES 预后的相关预测因子。选取在 Erlangen 癫痫中心的视频脑电图（VEEG）监测过程中被诊断为 PNES 的病例，病程 1～16 年。随访数据为心理症状问卷（贝克抑郁量表-II、症状清单-90-标准、分离症状问卷），人格特质（Freiburg 弗莱堡人格量表-修改版）和 HRQoL（36-项简短健康调查）。共纳入 52 例患者，平均年龄（40.5±14.0）岁，女性 75%，随访（5.3±4.2）年。在过去的 12 个月中，有 19 例（37%）患者 PNES 得到了缓解。持续性 PNES 患者在疾病首次发作（32.9 vs. 22.3 岁，P<0.01）和诊断（40.5 vs. 27.2 岁，P<0.001）时年龄较大，表现出较差的心理状态、较低的外向性人格和较低的生活满意度，同时 HRQoL 较非 PNES 患者更差。PNES 缓解患者在所有方面均处于正常范围内。PNES 的最佳缓解预测指标为发病时年龄较小和人格外向性。持续性 PNES 患者的预后较差，精神病理学指标较高且 HRQoL 较低，但可能因 PNES 的缓解而恢复正常。人格内向性高和年龄较大是持续性 PNES 的危险因素。

Citation： KatrinWalther, BastianVolbers, LauraErdmann, 林岷涛　译, 慕洁　审. 心因性非痫性发作的精神相关长期预后. Journal of Epilepsy, 2020, 6(5): 452-459. doi: 10.7507/2096-0247.20200074 Copy

1.	Bloch AM, Bloch Y, Kramer U. Psychogenic seizures: a review. Int J Adolesc Med Health, 2011, 12(Suppl): 71-86.
2.	Reuber M, Elger CE. Psychogenic nonepileptic seizures: review and update. Epilepsy Behav, 2003, 4: 205-216.
3.	Bodde N, Brooks J, Baker G, <italic>et al</italic>. Psychogenic non-epileptic seizures—definition, etiology, treatment and prognostic issues: a critical review. Seizure, 2009, 18(8): 543-553.
4.	Lempert T, Schmidt D. Natural history and outcome of psychogenic seizures: a clinical study in 50 patients. J Neurol, 1990, 237(1): 35-38.
5.	Jones B, Reuber M, Norman P. Correlates of health-related quality of life in adults with psychogenic nonepileptic seizures: a systematic review. Epilepsia, 2016, 57(2): 171-181.
6.	Wiseman H, Reuber M. New insights into psychogenic nonepileptic seizures 2011-2014. Seizure, 2015, 29: 69-80.
7.	Reuber M, Mitchell AJ, Howlett S, <italic>et al</italic>. Measuring outcome in psychogenic nonepileptic seizures: how relevant is seizure remission? Epilepsia, 2005, 46(11): 1788-1795.
8.	Jones SG, O'Brien TJ, Adams SJ, <italic>et al</italic>. Clinical characteristics and outcome in patients with psychogenic nonepileptic seizures. Psychosom Med, 2010, 72(5): 487-497.
9.	Reuber M, Pukrop R, Bauer J, <italic>et al</italic>. Outcome in psychogenic nonepileptic seizures: 1 to 10-year follow-up in 164 patients. Ann Neurol, 2003, 53(3): 305-311.
10.	Kuyk J, Siffels MC, Bakvis P, <italic>et al</italic>. Psychological treatment of patients with psychogenic non-epileptic seizures: an outcome study. Seizure, 2008, 17(7): 595-603.
11.	Reuber M, Pukrop R, Bauer J, <italic>et al</italic>. Multidimensional assessment of personality in patients with psychogenic non-epileptic seizures. J Neurol Neurosurg Psychiatry, 2004, 75(5): 743-748.
12.	Cragar DE, Berry DT, Schmitt FA, <italic>et al</italic>. Cluster analysis of normal personality traits in patients with psychogenic nonepileptic seizures. Epilepsy Behav, 2005, 6(4): 593-600.
13.	Quigg M, Armstrong RF, Farace E, <italic>et al</italic>. Quality of life outcome is associated with cessation rather than reduction of psychogenic nonepileptic seizures. Epilepsy Behav, 2002, 3(5): 455-459.
14.	Hautzinger M, Keller MF, Kühner C, et al. BDI-II. Beck-Depressions Inventar Revision. 2nd ed. Frankfurt, Germany: Person Assessment, 2009.
15.	Franke GH. SCL-90®-S. Symptom-Checklist-90®-StandardManual. Göttingen, Germany: Hogrefe, 2014.
16.	Spitzer C, Stieglitz R-D, Freyberger HJ. Fragebogen zu dissoziativen symptomen (FDS). Ein Selbstbeurteilungsverfahren zur syndromalen diagnositik dissoziativer phänomene. German adaptation of the dissociative experience scale (DES) by E. Bernstein-Carlson and F. W. Putnam (3rd. ed). Bern: Verlag Hans Huber, 2015.
17.	Bernstein EM, Putnam FW. Development, reliability, and validity of a dissociation scale. J Nerv Ment Dis, 1986, 174(12): 727-735.
18.	Fahrenberg J, Hampel R, Selg H. Das freiburger persönlichkeitsinventar (FPI-R). Göttingen: Hogrefe, 2001.
19.	Rohrmann S, Spinath FM. TBS-TK Rezensionen: FPI-R freiburger persönlichkeitsinventar. Psychol Rundsch, 2011, 62(2): 268-270.
20.	Morfeld M, Kirchberger I, Bullinger M. SF-36 Fragebogen zum gesundheitszustand: deutsche version des short form-36 health survey. Göttingen: Hogrefe, 2011.
21.	Duncan R, Graham CD, Oto M. Outcome at 5-10 years in psychogenic nonepileptic seizures: what patients report vs what family doctors report. Epilepsy Behav, 2014, 37: 71-74.
22.	Duncan R, Anderson J, Cullen B, <italic>et al</italic>. Predictors of 6-month and 3-year outcomes after psychological intervention for psychogenic non epileptic seizures. Seizure, 2016, 36: 22-26.
23.	Mayor R, Howlett S, Grünewald R, <italic>et al</italic>. Long-term outcome of brief augmented psychodynamic interpersonal therapy for psychogenic nonepileptic seizures: seizure control and health care utilization. Epilepsia, 2010, 51(7): 1169-1176.
24.	Selwa LM, Geyer J, Nikakhtar N, <italic>et al</italic>. Nonepileptic seizure outcome varies by type of spell and duration of illness. Epilepsia, 2000, 41(10): 1330-1334.
25.	Asadi-Pooya AA, Ziyaee F. Outcome of patients with psychogenic nonepileptic seizures with limited resources: a longitudinal study. Seizure, 2018, 59: 1-4.
26.	Hall-Patch L, Brown R, House A, <italic>et al</italic>. Acceptability and effectiveness of a strategy for the communication of the diagnosis of psychogenic nonepileptic seizures. Epilepsia, 2010, 51(1): 70-78.
27.	Mayor R, Brown R, Cock H, <italic>et al</italic>. Short-term outcome of psychogenic non-epileptic seizures after communication of the diagnosis. Epilepsy Behav, 2012, 25(4): 676-681.
28.	Ettinger AB, Devinsky O, Weisbrot DM, <italic>et al</italic>. A comprehensive profile of clinical, psychiatric, and psychosocial characteristics of patients with psychogenic nonepileptic seizures. Epilepsia, 1999, 40(9): 1292-1298.
29.	Walczak TS, Papacostas S, Williams DT, <italic>et al</italic>. Outcome after diagnosis of psychogenic nonepileptic seizures. Epilepsia, 1995, 36(11): 1131-1137.
30.	LaFrance WC, Baird GL, Barry JJ, <italic>et al</italic>. Multicenter pilot treatment trial for psychogenic nonepileptic seizures: a randomized clinical trial. JAMA Psychiatry, 2014, 71(9): 997-1005.
31.	Gasparini S, Beghi E, Ferlazzo E, <italic>et al</italic>. Management of psychogenic nonepileptic seizures (PNES): a multidisciplinary approach. Eur J Neurol, 2019, 26(2): 205-215.
32.	Wyllie E, Friedman D, Lüders H, <italic>et al</italic>. Outcome of psychogenic seizures in children and adolescents compared with adults. Neurology, 1991, 41(5): 742-744.
33.	Bodde NM, Janssen AM, Theuns C, <italic>et al</italic>. Factors involved in the long-term prognosis of psychogenic nonepileptic seizures. J Psychosom Res, 2007, 62(5): 545-551.
34.	Reuber M, House AO, Pukrop R, <italic>et al</italic>. Somatization, dissociation and general psychopathology in patients with psychogenic nonepileptic seizures. Epilepsy Res, 2003, 57(2-3): 159-167.
35.	Szaflarski JP, Szaflarski M. Seizure disorders, depression, and health-related quality of life. Epilepsy Behav, 2004, 5(1): 50-57.
36.	Baker GA, Jacoby A, Buck D, <italic>et al</italic>. Quality of life of people with epilepsy: a european study. Epilepsia, 1997, 38(2): 353-362.
37.	Russo J, Trujillo CA, Wingerson D, <italic>et al</italic>. The MOS 36-item short form health survey: reliability, validity, and preliminary findings in schizophrenic outpatients. Med Care, 1998, 36(5): 752-756.
38.	Lawton G, Mayor RJ, Howlett S, <italic>et al</italic>. Psychogenic nonepileptic seizures and health-related quality of life: the relationship with psychological distress and other physical symptoms. Epilepsy Behav, 2009, 14(1): 167-171.
39.	Ettinger AB, Devinsky O, Weisbrot DM, <italic>et al</italic>. Headaches and other pain symptoms among patients with psychogenic non-epileptic seizures. Seizure, 1999, 8(7): 424-426.
40.	Brown RJ, Reuber M. Psychological and psychiatric aspects of psychogenic non-epileptic seizures (PNES): a systematic review. Clin Psychol Rev, 2016, 45: 157-182.
41.	La France WC, Syc S. Depression and symptoms affect quality of life in psychogenic nonepileptic seizures. Neurology, 2009, 73(5): 366-371.
42.	Galimberti CA, Ratti MT, Murelli R, <italic>et al</italic>. Patients with psychogenic nonepileptic seizures, alone or epilepsy-associated, share a psychological profile distinct from that of epilepsy patients. J Neurol, 2003, 250(3): 338-346.
43.	Diprose W, Sundram F, Menkes DB. Psychiatric comorbidity in psychogenic nonepileptic seizures compared with epilepsy. Epilepsy Behav, 2016, 56: 123-130.
44.	Reilly C, Menlove L, Fenton V, <italic>et al</italic>. Psychogenic nonepileptic seizures in children: a review. Epilepsia, 2013, 54(10): 1715-1724.
45.	Morgan LA, Buchhalter J. Psychogenic paroxysmal nonepileptic events in children: a review. Pediatr Neurol, 2015, 53(1): 13-22.

1. Bloch AM, Bloch Y, Kramer U. Psychogenic seizures: a review. Int J Adolesc Med Health, 2011, 12(Suppl): 71-86.
2. Reuber M, Elger CE. Psychogenic nonepileptic seizures: review and update. Epilepsy Behav, 2003, 4: 205-216.
3. Bodde N, Brooks J, Baker G, <italic>et al</italic>. Psychogenic non-epileptic seizures—definition, etiology, treatment and prognostic issues: a critical review. Seizure, 2009, 18(8): 543-553.
4. Lempert T, Schmidt D. Natural history and outcome of psychogenic seizures: a clinical study in 50 patients. J Neurol, 1990, 237(1): 35-38.
5. Jones B, Reuber M, Norman P. Correlates of health-related quality of life in adults with psychogenic nonepileptic seizures: a systematic review. Epilepsia, 2016, 57(2): 171-181.
6. Wiseman H, Reuber M. New insights into psychogenic nonepileptic seizures 2011-2014. Seizure, 2015, 29: 69-80.
7. Reuber M, Mitchell AJ, Howlett S, <italic>et al</italic>. Measuring outcome in psychogenic nonepileptic seizures: how relevant is seizure remission? Epilepsia, 2005, 46(11): 1788-1795.
8. Jones SG, O'Brien TJ, Adams SJ, <italic>et al</italic>. Clinical characteristics and outcome in patients with psychogenic nonepileptic seizures. Psychosom Med, 2010, 72(5): 487-497.
9. Reuber M, Pukrop R, Bauer J, <italic>et al</italic>. Outcome in psychogenic nonepileptic seizures: 1 to 10-year follow-up in 164 patients. Ann Neurol, 2003, 53(3): 305-311.
10. Kuyk J, Siffels MC, Bakvis P, <italic>et al</italic>. Psychological treatment of patients with psychogenic non-epileptic seizures: an outcome study. Seizure, 2008, 17(7): 595-603.
11. Reuber M, Pukrop R, Bauer J, <italic>et al</italic>. Multidimensional assessment of personality in patients with psychogenic non-epileptic seizures. J Neurol Neurosurg Psychiatry, 2004, 75(5): 743-748.
12. Cragar DE, Berry DT, Schmitt FA, <italic>et al</italic>. Cluster analysis of normal personality traits in patients with psychogenic nonepileptic seizures. Epilepsy Behav, 2005, 6(4): 593-600.
13. Quigg M, Armstrong RF, Farace E, <italic>et al</italic>. Quality of life outcome is associated with cessation rather than reduction of psychogenic nonepileptic seizures. Epilepsy Behav, 2002, 3(5): 455-459.
14. Hautzinger M, Keller MF, Kühner C, et al. BDI-II. Beck-Depressions Inventar Revision. 2nd ed. Frankfurt, Germany: Person Assessment, 2009.
15. Franke GH. SCL-90®-S. Symptom-Checklist-90®-StandardManual. Göttingen, Germany: Hogrefe, 2014.
16. Spitzer C, Stieglitz R-D, Freyberger HJ. Fragebogen zu dissoziativen symptomen (FDS). Ein Selbstbeurteilungsverfahren zur syndromalen diagnositik dissoziativer phänomene. German adaptation of the dissociative experience scale (DES) by E. Bernstein-Carlson and F. W. Putnam (3rd. ed). Bern: Verlag Hans Huber, 2015.
17. Bernstein EM, Putnam FW. Development, reliability, and validity of a dissociation scale. J Nerv Ment Dis, 1986, 174(12): 727-735.
18. Fahrenberg J, Hampel R, Selg H. Das freiburger persönlichkeitsinventar (FPI-R). Göttingen: Hogrefe, 2001.
19. Rohrmann S, Spinath FM. TBS-TK Rezensionen: FPI-R freiburger persönlichkeitsinventar. Psychol Rundsch, 2011, 62(2): 268-270.
20. Morfeld M, Kirchberger I, Bullinger M. SF-36 Fragebogen zum gesundheitszustand: deutsche version des short form-36 health survey. Göttingen: Hogrefe, 2011.
21. Duncan R, Graham CD, Oto M. Outcome at 5-10 years in psychogenic nonepileptic seizures: what patients report vs what family doctors report. Epilepsy Behav, 2014, 37: 71-74.
22. Duncan R, Anderson J, Cullen B, <italic>et al</italic>. Predictors of 6-month and 3-year outcomes after psychological intervention for psychogenic non epileptic seizures. Seizure, 2016, 36: 22-26.
23. Mayor R, Howlett S, Grünewald R, <italic>et al</italic>. Long-term outcome of brief augmented psychodynamic interpersonal therapy for psychogenic nonepileptic seizures: seizure control and health care utilization. Epilepsia, 2010, 51(7): 1169-1176.
24. Selwa LM, Geyer J, Nikakhtar N, <italic>et al</italic>. Nonepileptic seizure outcome varies by type of spell and duration of illness. Epilepsia, 2000, 41(10): 1330-1334.
25. Asadi-Pooya AA, Ziyaee F. Outcome of patients with psychogenic nonepileptic seizures with limited resources: a longitudinal study. Seizure, 2018, 59: 1-4.
26. Hall-Patch L, Brown R, House A, <italic>et al</italic>. Acceptability and effectiveness of a strategy for the communication of the diagnosis of psychogenic nonepileptic seizures. Epilepsia, 2010, 51(1): 70-78.
27. Mayor R, Brown R, Cock H, <italic>et al</italic>. Short-term outcome of psychogenic non-epileptic seizures after communication of the diagnosis. Epilepsy Behav, 2012, 25(4): 676-681.
28. Ettinger AB, Devinsky O, Weisbrot DM, <italic>et al</italic>. A comprehensive profile of clinical, psychiatric, and psychosocial characteristics of patients with psychogenic nonepileptic seizures. Epilepsia, 1999, 40(9): 1292-1298.
29. Walczak TS, Papacostas S, Williams DT, <italic>et al</italic>. Outcome after diagnosis of psychogenic nonepileptic seizures. Epilepsia, 1995, 36(11): 1131-1137.
30. LaFrance WC, Baird GL, Barry JJ, <italic>et al</italic>. Multicenter pilot treatment trial for psychogenic nonepileptic seizures: a randomized clinical trial. JAMA Psychiatry, 2014, 71(9): 997-1005.
31. Gasparini S, Beghi E, Ferlazzo E, <italic>et al</italic>. Management of psychogenic nonepileptic seizures (PNES): a multidisciplinary approach. Eur J Neurol, 2019, 26(2): 205-215.
32. Wyllie E, Friedman D, Lüders H, <italic>et al</italic>. Outcome of psychogenic seizures in children and adolescents compared with adults. Neurology, 1991, 41(5): 742-744.
33. Bodde NM, Janssen AM, Theuns C, <italic>et al</italic>. Factors involved in the long-term prognosis of psychogenic nonepileptic seizures. J Psychosom Res, 2007, 62(5): 545-551.
34. Reuber M, House AO, Pukrop R, <italic>et al</italic>. Somatization, dissociation and general psychopathology in patients with psychogenic nonepileptic seizures. Epilepsy Res, 2003, 57(2-3): 159-167.
35. Szaflarski JP, Szaflarski M. Seizure disorders, depression, and health-related quality of life. Epilepsy Behav, 2004, 5(1): 50-57.
36. Baker GA, Jacoby A, Buck D, <italic>et al</italic>. Quality of life of people with epilepsy: a european study. Epilepsia, 1997, 38(2): 353-362.
37. Russo J, Trujillo CA, Wingerson D, <italic>et al</italic>. The MOS 36-item short form health survey: reliability, validity, and preliminary findings in schizophrenic outpatients. Med Care, 1998, 36(5): 752-756.
38. Lawton G, Mayor RJ, Howlett S, <italic>et al</italic>. Psychogenic nonepileptic seizures and health-related quality of life: the relationship with psychological distress and other physical symptoms. Epilepsy Behav, 2009, 14(1): 167-171.
39. Ettinger AB, Devinsky O, Weisbrot DM, <italic>et al</italic>. Headaches and other pain symptoms among patients with psychogenic non-epileptic seizures. Seizure, 1999, 8(7): 424-426.
40. Brown RJ, Reuber M. Psychological and psychiatric aspects of psychogenic non-epileptic seizures (PNES): a systematic review. Clin Psychol Rev, 2016, 45: 157-182.
41. La France WC, Syc S. Depression and symptoms affect quality of life in psychogenic nonepileptic seizures. Neurology, 2009, 73(5): 366-371.
42. Galimberti CA, Ratti MT, Murelli R, <italic>et al</italic>. Patients with psychogenic nonepileptic seizures, alone or epilepsy-associated, share a psychological profile distinct from that of epilepsy patients. J Neurol, 2003, 250(3): 338-346.
43. Diprose W, Sundram F, Menkes DB. Psychiatric comorbidity in psychogenic nonepileptic seizures compared with epilepsy. Epilepsy Behav, 2016, 56: 123-130.
44. Reilly C, Menlove L, Fenton V, <italic>et al</italic>. Psychogenic nonepileptic seizures in children: a review. Epilepsia, 2013, 54(10): 1715-1724.
45. Morgan LA, Buchhalter J. Psychogenic paroxysmal nonepileptic events in children: a review. Pediatr Neurol, 2015, 53(1): 13-22.

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