心因性非痫性发作患者的抑郁、焦虑症状及人格特质研究  

Study on depression, anxiety and personality traits in patients with psychogenic non-epileptic seizures

作　　者：冷海霞 薛青[1] 王玉平[1] Leng Haixia;Xue Qing;Wang Yuping(Department of Neurology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院神经内科,北京100053

出　　处：《神经疾病与精神卫生》2022年第11期818-822,共5页Journal of Neuroscience and Mental Health

基　　金：北京市临床重点专科卓越项目(2017YFC0907702);首都医科大学宣武医院国自然青年培育项目(QNPY2020007)。

摘　　要：目的 分析心因性非痫性发作(PNES)患者的抑郁、焦虑症状及人格特质。方法 选取2020年1月至2021年3月在首都医科大学宣武医院神经内科治疗的22例PNES患者(PNES组)及40例癫痫患者(癫痫组)的一般人口学及相关临床资料,使用24项汉密尔顿抑郁量表(HAMD-24)、汉密尔顿焦虑量表(HAMA)及明尼苏达多项人格测验(MMPI)评估患者的抑郁、焦虑状态及人格特质。比较两组患者一般人口学特征、临床资料、抑郁、焦虑状态及人格特质的差异。结果 PNES组本次发作有诱发因素者占比、发作频率高于癫痫组,差异有统计学意义(P<0.05);HAMA总分[11.80(7.00,15.50)分比8.50(5.00,14.00)分]、躯体性焦虑因子评分[5.30(2.00,9.50)分比3.10(1.00,4.75)分]、HAMD-24总分[10.60(5.50,14.50)分比7.30(5.00,8.50)分]、焦虑/躯体化症状因子评分[4.00(2.50,5.00)分比2.80(2.00,4.00)分]、睡眠障碍因子评分[1.80(0,3.00)分比1.00(0,2.00)分]、绝望感因子评分[1.10(0,2.00)分比0.40(0,1.50)分]高于癫痫组,差异有统计学意义(Z=2.13、1.98、1.97、2.64、2.15、2.76;P<0.05);PNES组MMPI中的疑病[(67.36±2.02)分比(56.79±1.21)分]、抑郁[(64.09±2.10)分比(52.07±1.97)分]、癔病[(67.00±1.79)分比(54.62±1.17)分]、精神衰弱的标准分[(65.55±2.15)分比(58.40±1.82)分]高于癫痫组,神经质[(71.32±2.05)分比(56.88±1.12)分]和掩饰性因子评分[(45.09±2.38)分比(38.57±0.98)分]高于癫痫组(t=4.77、4.15、6.00、2.41、6.74、2.53;P<0.05),非社会性因子评分低于癫痫组[(44.91±2.03)分比(53.24±1.63)分],差异有统计学意义(t=-3.10,P<0.01)。结论 PNES相对癫痫患者的抑郁、焦虑症状明显,具有神经质、掩饰性的人格特质,而癫痫患者的非社会化倾向更加明显。Objective To analyze the depression, anxiety symptoms and personality traits of patients with psychogenic non-epileptic seizures(PNES). Methods The general demographic and related clinical data of 22 patients with psychogenic non epileptic seizures(PNES group) and 40 patients with epilepsy(epilepsy group) from the Department of Neurology, Xuanwu Hospital, Capital Medical University from January 2020to March 2021 were collected. The depression, anxiety and personality traits of the patients were evaluated by Hamilton Depression Scale(HAMD), Hamilton Anxiety Scale(HAMA) and Minnesota Multiphasic Personality Inventory(MMPI). The differences between the two groups in general demographic characteristics, clinical data, depression, anxiety and personality traits were compared and analyzed. Results The proportion of seizure with inducing factors and seizure frequency in the PNES group were significantly higher than those in the epilepsy group(P < 0.05). In the PNES group, the total score of HAMA [11.80(7.00,15.50) vs 8.50(5.00,14.00)], somatic anxiety factor [5.30(2.00,9.50) vs 3.10(1.00,4.75)], total score of HAMD [10.60(5.50,14.50) vs 7.30(5.00,8.50)], anxiety somatization factor [4.00(2.50,5.00) vs 2.80(2.00,4.00)], sleep disorder factor [1.80(0,3.00) vs 1.00(0,2.00)], and the despair factor [1.10(0,2.00) vs 0.40(0,1.50)] were significantly higher than those of epilepsy group(Z=2.13,1.98,1.97,2.64,2.15,2.76;P<0.05). The standard scores of hypochondriasis [(67.36±2.02) vs(56.79±1.21)], depression [(64.09±2.10) vs(52.07±1.97)], hysteria [(67.00±1.79) vs(54.62±1.17)], neurasthenia [(65.55±2.15) vs(58.40±1.82)] in MMPI of PNES group were higher than those of epilepsy group;The score of neuroticism [(71.32±2.05) vs(56.88±1.12)] and masked factor [(45.09±2.38) vs(38.57±0.98)] in PNES group were significantly higher than those in epilepsy group(t=4.77,4.15, 6.00,2.42,6.72,2.53;P<0.05). The non-social factor in PNES group was lower than that in epilepsy group [(44.91±2.03) vs(53.24±1.63)], and the difference wa

关 键 词：癫痫 心因性非痫性发作 抑郁 焦虑 人格特质 

分 类 号：R749[医药卫生—神经病学与精神病学]