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首页> 美国卫生研究院文献>Frontiers in Psychiatry >Suicidal Ideation and Traumatic Exposure Should Not Be Neglected in Epileptic Patients: A Multidimensional Comparison of the Psychiatric Profile of Patients Suffering From Epilepsy and Patients Suffering From Psychogenic Nonepileptic Seizures
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Suicidal Ideation and Traumatic Exposure Should Not Be Neglected in Epileptic Patients: A Multidimensional Comparison of the Psychiatric Profile of Patients Suffering From Epilepsy and Patients Suffering From Psychogenic Nonepileptic Seizures

机译：癫痫患者的自杀意念和创伤暴露不容忽视：癫痫患者和精神病性非癫痫性发作患者的精神病学特征的多维比较

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>Introduction: Patients with psychogenic nonepileptic seizures (PNESs) have often been exposed to traumatic events, which is a risk factor for suicidal behavior. This would suggest that the severity of suicidal ideation is greater in PNES than in patients suffering only from epileptic seizures (ESs). However, these psychiatric symptoms may be underestimated in the ES population. The specific features or similarities between the psychiatric clinical profiles of these two groups should be elaborated to improve therapeutic management. Our study is the first to compare suicidal ideation, suicide risk, posttraumatic stress disorder (PTSD), and depression disorder simultaneously in both groups, in a tertiary care epilepsy center. >Material and methods: We prospectively enrolled patients hospitalized for video-electroencephalography (EEG) monitoring to assess repeated seizures before an ES or a PNES diagnosis was made. During the psychiatric consultation that accompanied the video EEG, we rated the severity of suicidal ideation and depressive symptoms, suicidal risk, traumatic exposure history, and PTSD symptoms. >Results: Eighteen subjects were enrolled and diagnosed with PNES, and 42, with ES. The PNES group reported more exposures to traumatic events and more intense PTSD symptoms (median: 17 vs. 27; p = 0.001). The severity of suicidal ideation did not differ significantly between the two groups. >Conclusion: It is the severity of PTSD symptoms in PNES patients that differentiates them from ES patients, although exposure to traumatic events is also frequent in ES patients. We demonstrated that suicidal ideation and suicide risk are equally high in the ES and PNES groups. Therefore, both groups require extreme vigilance in terms of suicidal risk.
机译：>简介：患有精神病性非癫痫性发作（PNESs）的患者经常会遭受创伤事件，这是自杀行为的危险因素。这表明，在PNES中，自杀意念的严重性要比仅患有癫痫发作（ESs）的患者要大。但是，这些精神病症状在ES人群中可能被低估了。这两组患者的精神病学临床特征之间的具体特征或相似之处应加以详细阐述，以改善治疗管理。我们的研究首次在三级保健癫痫中心比较了两组的自杀意念，自杀风险，创伤后应激障碍（PTSD）和抑郁症。 >材料和方法：我们前瞻性地招募了住院患者进行视频脑电图（EEG）监测，以评估在做出ES或PNES诊断之前是否反复发作。在视频EEG随附的精神病咨询期间，我们对自杀意念和抑郁症状，自杀风险，外伤史和PTSD症状的严重程度进行了评估。 >结果：18名受试者被诊断为PNES，42名受试者被诊断为ES。 PNES组报告了更多的创伤事件暴露和更严重的PTSD症状（中位数：17对27； p = 0.001）。两组之间自杀意念的严重程度没有显着差异。 >结论：PNES患者中PTSD症状的严重程度将其与ES患者区分开，尽管ES患者中也经常暴露于创伤事件。我们证明，ES和PNES组的自杀意念和自杀风险均很高。因此，这两个群体都需要在自杀风险方面保持高度警惕。

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