The value of pseudoneurological symptoms for assessing psychopathology in primary
The value of pseudoneurological symptoms for assessing psychopathology in primary
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DOI：
10.1097/01.psy.0000107883.14385.ec
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发表时间：
2004-01-01
影响因子：
3.3
通讯作者：
Manetti-Cusa, J
中科院分区：
文献类型：
--
作者：
Interian, A;Gara, MA;Manetti-Cusa, J
目的：本研究旨在探讨假神经症状（PNS）与躯体和精神症状严重程度、身体功能和精神合并症之间的关系。方法：对120例躯体化患者进行访谈和问卷调查，以评估认知行为疗法的疗效。测量得到了关于精神诊断、焦虑和抑郁症状水平、躯体症状和身体功能的信息。统计分析了PNS与躯体化障碍诊断、躯体和精神症状严重程度以及精神合并症的关系。结果：大约一半的样本有四次或更多的PNS病史。结果显示，有四个或更多的PNS不能预测躯体化障碍。然而，有四个或更多的PNS被发现与焦虑、抑郁、躯体疾病和身体功能障碍的严重程度显著相关。在控制非假性神经症状的症状数、躯体化障碍的存在和慢性疼痛身体状况的存在的情况下，确定了这些关联。此外，有四个或更多的PNS与接受诊断为重度抑郁症、心境恶劣、惊恐障碍和广泛性焦虑症的可能性显著相关。结论：在初级保健的躯体化患者中，四次或以上PNS病史很常见，并且与更严重的临床表现相关，即使在控制了已知与严重程度相关的其他因素后也是如此。四个或更多的PNS可以识别躯体化的不同亚组，并作为初级保健中识别精神疾病的临床指标。未来的研究应探索使用更简短的措施来评估PNS。此外，PNS应该用更能代表美国初级保健人群的样本进行评估，以及包括其他种族背景（例如，非裔美国人，亚洲人等）足够代表性的样本。
Objective: This study sought to examine the relationship between pseudoneurological symptoms (PNS) and somatic and psychiatric symptom severity, physical functioning, and psychiatric comorbidity. Methods: Interview and questionnaire data were obtained from 120 patients with somatization who participated in a study assessing the efficacy of cognitive-behavioral therapy. Measures elicited information on psychiatric diagnoses, anxiety and depressive symptom levels, somatic symptoms, and physical functioning. Statistical analyses examined the relationship between PNS and the diagnosis of somatization disorder, physical and psychiatric symptom severity, and psychiatric comorbidity. Results: Roughly half of the sample had a history of four or more PNS. Results showed that having four or more PNS was not predictive of somatization disorder. However, having four or more PNS was found to be significantly correlated with the severity of anxiety, depression, somatic complaints, and physical dysfunction. These associations were identified while controlling for the symptom count of nonpseudoneurological symptoms, the presence of somatization disorder, and the presence of chronic painful physical conditions. In addition, having four or more PNS was significantly associated with a higher likelihood of receiving a diagnosis of major depression, dysthymia, panic disorder, and generalized anxiety disorder. Conclusions: A history of four or more PNS is common among somatizing patients in primary care and associated with a more severe clinical presentation, even after controlling for other factors known to be associated with severity. Four or more PNS may identify a distinct subgroup of somatization and serve as a clinical indicator for identifying psychiatric disorders in primary care. Future studies should explore the assessment of PNS using briefer measures. Furthermore, PNS should be evaluated with samples more representative of US primary care populations, as well as samples that include adequate representation from other ethnic backgrounds (eg, African-American, Asian, etc.).