Epidemiology
Epidemiology
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DOI：
10.1016/b978-0-12-801772-2.00005-9
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发表时间：
2016-01-01
期刊：
影响因子：
--
通讯作者：
Lehn, A.
中科院分区：
文献类型：
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作者：
Carson, A.;Lehn, A.
功能性神经障碍（FND）的流行病学是复杂的，多年来由于缺乏明确的定义而受到阻碍，以前的定义与身体和心理成分的不稳定混合在一起。最近DSM-5对基于与神经系统疾病不一致和不一致的身体症状的阳性识别的定义的修改以及对任何相关精神病理学的缺乏需要代表了在澄清障碍方面向前迈出的重要一步。在此基础上，FND约占神经科门诊接触者的6%，推定的社区发病率为每年每10万人4-12人。共病神经系统疾病发生在大约10%的病例中。诊断可靠，翻修率低于5%。值得注意的是，在广泛使用计算机断层扫描和磁共振成像之前，该翻修率是一致的。FND症状是致残性的，并与显著的痛苦有关。它们在女性中更常见，在35岁至50岁之间发病率最高;然而，在男性和整个生命周期中，这种表现很常见。围绕案件的定义，查明，误诊和风险因素的问题进行了详细讨论。
The epidemiology of functional neurologic disorders (FND) is complex and has been hampered over the years by a lack of clear definition, with previous definitions struggling with an uneasy mix of both physical and psychologic components. The recent changes inDSM-5 to a definition based on positive identification of physical symptoms which are incongruent and inconsistent with neurologic disease and the lack of need for any associated psychopathology represent a significant step forward in clarifying the disorder. On this basis, FND account for approximately 6% of neurology outpatient contacts and putative community incidence rates of 4-12 per 100 000 per annum. Comorbid neurologic disease occurs in around 10% of cases. The diagnosis is reliable, with revision rates less than 5%. Of note, this revision rate was consistent prior to the widespread utilization of computed tomography and magnetic resonance imaging. FND symptoms are disabling and associated with significant distress. They are more common in women and have a peak incidence between the ages of 35 and 50; however the presentation is common in men and throughout the lifespan. The issues surrounding case definition, ascertainment, misdiagnosis, and risk factors are discussed in detail.