Psychiatric and personality factors in pediatric functional seizures: A prospective case-control study.
Psychiatric and personality factors in pediatric functional seizures: A prospective case-control study.
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DOI：
10.1016/j.seizure.2022.04.006
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发表时间：
2022-05
影响因子：
3
通讯作者：
Fobian, Aaron D.
中科院分区：
文献类型：
--
作者：
Stager, Lindsay;Morriss, Skylar;Szaflarski, Jerzy P.;Fobian, Aaron D.
本研究评估了与儿童功能性癫痫发作（FS）相关的精神和人格特征。在1：1的前瞻性配对对照研究设计中，将有记录的FS儿童（通过视频EEG确认;年龄13-18岁）与收入，性别，种族和年龄的对照组（MC）进行匹配。主要结果是儿童行为评估系统，第二版（BASC-2）和Millon青少年临床调查表（MACI）。次要指标包括评估创伤、躯体化、身体意识和生活质量（QOL）的问卷。T检验研究了组间T评分的差异。由于缺乏显著的结果，进行了实验分析，评估组间临床升高的BASC-2和MACI评分的数量差异。二元逻辑回归确定了临床评分升高对参与者FS可能性的影响。t检验评估了次要指标的差异。参与者包括84名儿童，42名FS和42名MC（FS儿童：平均值=15.4，四分位数间距=3; 73.5%女性; 59.5%白色）。与MC相比，FS儿童在BASC-2上有更大的父母报告的躯体化（t（23）=5.67，p<0.001），在CSSI-24上有更大的躯体化（t（35）=6.83，p<0.001），QOL更差（t（41）=-6.22; p<0.001）。与MC相比，临床升高的BASC-2或MACI评分没有差异，临床升高的评分不影响参与者有FS的可能性。FS儿童有更大的躯体化和较差的生活质量，但类似的精神症状，创伤和适应不良的人格特质相比，MC的比率。精神或人格因素不能预测FS的可能性。儿科FS的诊断应考虑FS的新贡献者，而不是仅仅依赖于精神病因。
This study assessed psychiatric and personality characteristics in relation to pediatric functional seizures (FS). In a 1:1 prospectively matched-control study design, children with documented FS (confirmed via video EEG; ages 13–18) were matched to controls (MCs) on income, sex, race, and age. Primary outcomes were Behavior Assessment System for Children, Second Edition (BASC-2) and Millon Adolescent Clinical Inventory (MACI). Secondary measures included questionnaires assessing trauma, somatization, body awareness and quality of life (QOL). T-tests investigated differences between groups on T-scores. Due to lack of significant outcomes, an experimental analysis was conducted assessing differences in number of clinically elevated BASC-2 and MACI scores between groups. Binary logistic regressions determined the influences of clinically elevated scores on likelihood participants have FS. T-tests assessed differences on secondary measures. Participants included 84 children, 42 with FS and 42 MCs (Children with FS: Meanage=15.4, Interquartile Rangeage=3; 73.5% female; 59.5% white). Children with FS had greater parent-reported somatization (t(23)=5.67, p<0.001) on BASC-2, greater somatization on CSSI-24 (t(35)=6.83, p<0.001), and poorer QOL (t(41)=−6.22; p<0.001) than MCs. There were no differences in clinically elevated BASC-2 or MACI scores compared to MCs and clinically elevated scores did not influence likelihood participants have FS. Children with FS had greater somatization and poorer QOL but similar rates of psychiatric symptoms, trauma, and maladaptive personality traits compared to MCs. Psychiatric or personality factors did not predict likelihood of FS. Explanations of pediatric FS should consider novel contributors to FS rather than relying solely on a psychiatric etiology.
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