뇌전증 및 정신성발작 환자의 MMPI 프로파일 비교
Comparison of MMPI Profile Patterns between Patients with Epileptic Seizures and Psychogenic Non-Epileptic Seizures
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Background: Psychogenic non epileptic seizures (PNES) are characterized by repeated seizures that are typically caused by stress and psychologic problems such as anxiety and depression. This contrasts with epileptic seizures (ES), which are transient and caused by irregular excitement of nerve cells. PNES can be found in patients with ES, but due to their differing etiologies, it is important to determine the psychologic characteristics that differentiate PNES from ES. Methods: This study identified psychopathologic and personality traits in 137 patients with PNES (n=7, 49.3% female) or ES (n=0, 35.7% female) using MMPI. The diagnosis was based on a medical history of seizures and the clinical examination in patients who visited the epilepsy clinic. Statistical analyses for comparing MMPI differences between the two groups were conducted using the t-test, chi-square test, and analysis of covariance. Results: We analyzed the frequency of individuals who exhibited a T score of ≥5 on the MMPI, and the results indicated that there were significantly more patients in the PNES group than in the ES group who had elevated scores on the hypochondriasis (Hs) scale and hysteria (Hy) scale. The mean scores of Hs, Hy, paranoia scale and schizophrenia scale were significantly higher in the PNES group than in the ES group. Conclusions: These results suggest that patients with PNES have greater psychologic problems than ES patients. Differences in MMPI profile patterns between patients with PNES and ES may be helpful in tailoring appropriate therapeutic interventions for the two groups.
Abstract
Background: Psychogenic non epileptic seizures (PNES) are characterized by repeated seizures that are typically caused by stress and psychologic problems such as anxiety and depression. This contrasts with epileptic seizures (ES), which are transient and caused by irregular excitement of nerve cells. PNES can be found in patients with ES, but due to their differing etiologies, it is important to determine the psychologic characteristics that differentiate PNES from ES. Methods: This study identified psychopathologic and personality traits in 137 patients with PNES (n=7, 49.3% female) or ES (n=0, 35.7% female) using MMPI. The diagnosis was based on a medical history of seizures and the clinical examination in patients who visited the epilepsy clinic. Statistical analyses for comparing MMPI differences between the two groups were conducted using the t-test, chi-square test, and analysis of covariance. Results: We analyzed the frequency of individuals who exhibited a T score of ≥5 on the MMPI, and the results indicated that there were significantly more patients in the PNES group than in the ES group who had elevated scores on the hypochondriasis (Hs) scale and hysteria (Hy) scale. The mean scores of Hs, Hy, paranoia scale and schizophrenia scale were significantly higher in the PNES group than in the ES group. Conclusions: These results suggest that patients with PNES have greater psychologic problems than ES patients. Differences in MMPI profile patterns between patients with PNES and ES may be helpful in tailoring appropriate therapeutic interventions for the two groups.
참고문헌 (40)
- Fisher RS, "ILAE official report: a practical clinical definition of epilepsy", Epilepsia, 55, pp.475~482 (2014)
- Fisher RS, "Epileptic seizures and epilepsy: definitions proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE)", Epilepsia, 46, pp.470~472 (2005)
- Youn SY, "The relationship of stigma and quality of life in patients with epilepsy", J Korean Epilep Soc, 5, pp.172~176 (2001)
- Owczarek K, "Personality Profiles of Patients with Psychogenic Nonepileptic Seizures, Epilepsy - Histological, Electroencephalographic and Psychological Aspects" (2012), InTech
- Lesser RP, "Psychogenic seizures", Neurology, 46, pp.1499~1507 (1996)
- Mellers JD, "The approach to patients with “non-epileptic seizures”", Postgrad Med J, 81, pp.498~504 (2005)
- Binder LM, "Psychogenic nonepileptic seizures", Neuropsychol Rev, 17, pp.405~412 (2007)
- Bodde NM, "Psychogenic non-epileptic seizures--diagnostic issues: a critical review", Clin Neurol Neurosurg, 111, pp.1~9 (2009)
- Reuber M, "Psychogenic nonepileptic seizures: review and update", Epilepsy Behav, 4, pp.205~216 (2003)
- Bailles E, "Psychiatric disease in patients with psychogenic non-epileptic seizures referred from an epilepsy unit in a general hospital", Actas Esp Psiquiatr, 32, pp.76~81 (2004)
- Wyllie E, "Outcome of psychogenic seizures in children and adolescents compared with adults", Neurology, 41, pp.742~744 (1991)
- Galimberti CA, "Patients with psychogenic nonepileptic seizures, alone or epilepsyassociated, share a psychological profile distinct from that of epilepsy patients", J Neurol, 250, pp.338~346 (2003)
- Bodde NM, "Factors involved in the long-term prognosis of psychogenic nonepileptic seizures", J Psychosom Res, 62, pp.545~551 (2007)
- Kuyk J, "The diagnosis of psychogenic non-epileptic seizures: a review", Seizure, 6, pp.243~253 (1997)
- Prigatano GP, "Psychological factors in the genesis and management of nonepileptic seizures: clinical observations", Epilepsy Behav, 3, pp.343~349 (2002)
- Reuber M, "Psychogenic nonepileptic seizures: review and update", Epilepsy Behav, 4, pp.205~216 (2003)
- LaFrance WC, "The treatment of nonepileptic seizures:historical perspectives and future directions", Epilepsia, 45, pp.15~21 (2004)
- Baslet G, "Heterogeneity in psychogenic nonepileptic seizures: understanding the role of psychiatric and neurological factors", Epilepsy Behav, 17, pp.236~241 (2010)
- Swinkels WA, "Psychiatric comorbidity in epilepsy", Epilepsy Behav, 7, pp.37~50 (2005)
- Tellez-Zenteno JF, "Psychiatric comorbidity in epilepsy: a population-based analysis", Epilepsia, 48, pp.2336~2344 (2007)
- Gordon PC, "A review of the clinical approach and challenges to psychogenic non-epileptic seizures", Mol Cel Epilepsy, 1, pp.e369~ (2014)
- Abubakr A, "Psychogenic seizures: clinical features and psychological analysis", Epilepsy Behav, 4, pp.241~245 (2003)
- Witgert ME, "Frequency of panic symptoms in psychogenic nonepileptic seizures", Epilepsy Behav, 6, pp.174~178 (2005)
- Griffith NM, "Relationship between semiology of psychogenic nonepileptic seizures and Minnesota Multiphasic Personality Inventory profile", Epilepsy Behav, 11, pp.105~111 (2007)
- Owczarek K, "Anxiety as a differential factor in epileptic versus psychogenic pseudoepileptic seizures", Epilepsy Res, 52, pp.227~232 (2003)
- Moon HG, "The Differential Diagnosis of Epilepsy in Children: Non-epileptic Seizure-like Events", J Korean Child Neurol Soc, 2, pp.87~92 (1995)
- Kim JH, "Clinical Study of Differential Diagnosis between Childhood Convulsive Disorders and Nonepileptic Paroxysmal Disorders", J Korean Child Neurol Soc, 6, pp.306~313 (1995)
- Oh E, "Characteristics of Psychogenic Non-Epileptic Seizure Patients using MMPI Profiles", J Korean Epilepsy Soc, 15, pp.10~16 (2011)
- Butcher JN, "The Minnesota Multiphasic Personality Inventory-2 (MMPI-2) Manual for Administration and Scoring", pp.8~17 (1989), University of Minneapolis Press
- 한경희, "한국판 MMPI-2의 개발 연구", Korean Journal of Clinical Psychology, 25(2), pp.533~564 (2006), 한국임상심리학회
- Graham JR, "MMPI-2: Assessing Personality and Psychopathology", pp.19~30 (2005), Oxford University Press
- Feingold A, "Gender differences in personality: a meta-analysis", Psychol Bull, 116, pp.429~456 (1994)
- Wyllie E, "Outcome of psychogenic seizures in children and adolescents compared with adults", Neurology, 41, pp.742~744 (1991)
- Binder LM, "Psychogenic nonepileptic seizures", Neuropsychol Rev, 17, pp.405~412 (2007)
- Cragar DE, "A review of diagnostic techniques in the differential diagnosis of epileptic and nonepileptic seizures", Neuropsychol Rev, 12, pp.31~64 (2002)
- Owczarek K, "Somatisation indexes as differential factors in psychogenic pseudoepileptic and epileptic seizures", Seizure, 12, pp.178~181 (2003)
- Kalogjera-Sackllares D, "Personality profiles of patients with pseduseizure", Seizure, 6, pp.1~7 (1997)
- Bodde NM, "MMPI-II personality profiles of patients with psychogenic nonepileptic seizures", Epilepsy Behav, 20, pp.674~680 (2011)
- Myers L, "Prevalence of alexithymia in patients with psychogenic non-epileptic seizures and epileptic seizures and predictors in psychogenic non-epileptic seizures", Epilepsy Behav, 26, pp.153~157 (2013)
- Owczarek K, "Patients with coexistent psychogenic pseudoepileptic and epileptic seizures: a psychological profile", Seizure, 10, pp.566~569 (2001)
