Slater revisited: 6 year follow up study of patients with medically unexplained motor symptoms
Slater revisited: 6 year follow up study of patients with medically unexplained motor symptoms
复制标题
DOI：
10.1136/bmj.316.7131.582
复制
发表时间：
1998-02-21
影响因子：
--
通讯作者：
Ron, MA
中科院分区：
文献类型：
--
作者：
Crimlisk, HL;Bhatia, K;Ron, MA
目的：调查先前被确定患有伦敦医学上无法解释的运动症状的患者的精神和神经发病诊断稳定性和预后指标。设计：随访研究。地点：国立神经病学和神经外科医院；伦敦——一家治疗神经系统疾病的二级和三级转诊医院。受试者：1989-91 年连续入院的 73 名患有医学上无法解释的汽车旅馆症状的患者。 35 名 (48%) 患者缺乏运动功能（例如偏瘫），35 名（52%）患者运动活动异常（例如震颤肌张力障碍或共济失调）。 主要结果指标：由神经科医生进行面对面重新评估的神经临床诊断，以及在标准化评估面谈（情感障碍和精神分裂症时间表）后进行的精神科诊断，由结果：64 名受试者 (88%) 获得了良好的随访数据。只有三名受试者在随访中出现新的器质性神经系统疾病，这完全或部分解释了他们之前的症状。 44/59 (75%) 受试者患有精神疾病；在 33 名 (75%) 患者中，精神病学诊断与其无法解释的运动症状相符。 31/59 (45%) 患者患有人格障碍：三名受试者在随访时出现了新的精神疾病，但只有一名受试者的诊断解释了之前的运动症状。身体症状的缓解与症状的长度、合并的精神疾病以及随访期间婚姻状况的范围有关。结论：与 1965 年 Slater 的研究不同，发现解释这些患者的症状或残疾的身体或精神诊断的发生率较低。然而，存在较高水平的精神共病。
Objective: To investigate psychiatric and neurological morbidity diagnostic stability and indicators of prognosis in patients previously identified as having London medically unexplained motor symptoms.Design: Follow up study.Setting: National Hospital for Neurology and Neurosurgery; London-a secondary and tertiary referral hospital for neurological disorders.Subjects: 73 patients with medically unexplained motel symptoms admitted consecutively in 1989-91. 35 (48%) patients had absence of motor function (for example, hemiplegia) and 35 (52%,) had abnormal motor activity (for example, tremour dystonia, or ataxia).Main outcome measures: Neurological clinical diagnosis at face to face reassessment by a neurologist and a psychiatric diagnosis after a standardised assessment interview-the schedule for affective disorders and schizophrenia-conducted by a psychiatrist.Results: Good follow up data were available for 64 subjects (88%). Only three subjects had new organic neurological disorders at follow up that fully or partly explained their previous symptoms. 44/59 (75%) subjects had had psychiatric disorders; in 33 (75%) patients, the psychiatric diagnosis coincided with their unexplained motor symptoms. 31/59 (45%) patients had a personality disorder: Three subjects had developed new psychiatric illnesses at follow up, but in only one did the diagnosis account for the previous motor symptoms. Resolution of physical symptoms was associated with shaft length of symptoms, comorbid psychiatric disorder, and a cl-range in marital status during follow up.Conclusions: Unlike Slater's study of 1965, a low incidence of physical or psychiatric diagnoses which explained these patients' symptoms or disability was found. However, a high level of psychiatric comorbidity existed.