Sex differences in demographic and clinical characteristics of psychogenic nonepileptic seizures: A retrospective multicenter international study
Sex differences in demographic and clinical characteristics of psychogenic nonepileptic seizures: A retrospective multicenter international study
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DOI：
10.1016/j.yebeh.2019.05.045
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发表时间：
2019-08-01
影响因子：
2.6
通讯作者：
Nicholson, Imothy
中科院分区：
文献类型：
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作者：
Asadi-Pooya, Ali A.;Myers, Lorna;Nicholson, Imothy
目的：神经和精神疾病患者的性别相关差异已被报道。我们也可以合理地假设，女性和男性在心因性非癫痫性发作（PNES）方面可能存在差异。方法：在这项回顾性研究中，我们调查了在伊朗、美国、加拿大、巴西、阿根廷和委内瑞拉中心癫痫监测部门住院的PNES患者。对所有患者的年龄、性别、癫痫发作年龄、癫痫符号学、可能诱发PNES的因素以及视频脑电图记录进行常规登记。结果：451例患者仅患有pnes，符合纳入条件；女性305例（67.6%）。我们进行了逻辑回归分析，评估单变量分析中的重要变量（即年龄、发病年龄、气场、是否有性虐待或身体虐待史以及家庭功能障碍）。唯一有意义的变量是性侵史（p = 0.005）和先兆的存在（p = 0.01）；身体虐待处于临界显著（p = 0.05）（这三种情况在女性中更为普遍）。结论：在PNES的人口学特征和临床特征方面，女性和男性的相似性大于差异。然而，值得注意的区别是，女性更经常报告一生的不良经历（性虐待，可能还有身体虐待）和光环。虽然社会、心理和遗传因素可能与PNES初期的终生不良经历相互作用，但两者之间的联系尚不清楚。这是未来研究的一个有趣途径。(C) 2019 Elsevier Inc.版权所有。
Purpose: Sex-related differences have been reported in patients with neurological and psychiatric disorders. It is also plausible to assume that there might be differences between females and males with psychogenic nonepileptic seizures (PNES).Methods: In this retrospective study, we investigated patients with PNES, who were admitted to the epilepsy monitoring units at centers in Iran, the USA, Canada, Brazil, Argentina, and Venezuela. Age, sex, age at seizure onset, seizure semiology, factors potentially predisposing to PNES, and video-electroencephalography recording of all patients were registered routinely.Results: Four hundred and fifty-one patients had PNES-only and were eligible for inclusion; 305 patients (67.6%) were females. We executed a logistic regression analysis, evaluating significant variables in univariate analyses (i.e., age, age at onset, aura, presence of historical sexual or physical abuse, and family dysfunction). The only variables retaining significance were historical sexual abuse (p = 0.005) and presence of aura (p = 0.01); physical abuse was borderline significant (p = 0.05) (all three were more prevalent among females).Conclusion: Similarities between females and males outweigh the differences with regard to the demographic and clinical characteristics of PNES. However, notable differences are that females more often report lifetime adverse experiences (sexual and probably physical abuse) and auras. While social, psychological, and genetic factors may interact with lifetime adverse experiences in the inception of PNES, the link is not yet clear. This is an interesting avenue for future studies. (C) 2019 Elsevier Inc. All rights reserved.