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Luca A, Lo Castro T, Mostile G, Donzuso G, Cicero CE, Nicoletti A, Zappia M. Personality and psychopathological characteristics in functional movement disorders. PLoS One 2024; 19:e0303379. [PMID: 38728293 PMCID: PMC11086865 DOI: 10.1371/journal.pone.0303379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 04/24/2024] [Indexed: 05/12/2024] Open
Abstract
INTRODUCTION Aim of the present study was to assess personality and psychopathological characteristics in patients with functional movement disorders (FMDs) compared to patients with other neurological disorders (OND). METHODS In this cross-sectional study, patients affected by clinically established FMDs and OND who attended the Neurologic Unit of the University-Hospital "Policlinico-San Marco" of Catania from the 1st of December 2021 to the 1st of June 2023 were enrolled. Personality characteristics were assessed with the Rorschach test coded according to Exner's comprehensive system and the Structured Clinical Interview for DSM-5 (SCID-II). RESULTS Thirty-one patients with FMDs (27 women; age 40.2±15.5 years; education 11.7±3.2 years; disease duration 2.3±2.5 years) and 24 patients affected by OND (18 women; age 35.8±16.3 years; education 11.9±2.9 years; disease duration 3.4±2.8 years) were enrolled. At the Rorschach, FMDs presented a significantly higher frequency of Popular (P) and sum of all Human content codes (SumH>5) responses and avoidant coping than OND. CONCLUSION FMDs presented "conformity behaviors", excessive interest in others than usual a maladaptive avoidant style of coping and a difficulty in verbalizing emotional distress. These psychopathological characteristics may favor the occurrence of FMDs.
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Affiliation(s)
- Antonina Luca
- Department of Medicine and Surgery, Kore University of Enna, Enna, Italy
| | - Tiziana Lo Castro
- Department of Medical, Surgical Sciences and Advanced Technologies, GF Ingrassia, University of Catania, Catania, Italy
| | - Giovanni Mostile
- Department of Medical, Surgical Sciences and Advanced Technologies, GF Ingrassia, University of Catania, Catania, Italy
- Oasi Research Institute-IRCCS Troina, Troina, Italy
| | - Giulia Donzuso
- Department of Medical, Surgical Sciences and Advanced Technologies, GF Ingrassia, University of Catania, Catania, Italy
| | - Calogero Edoardo Cicero
- Department of Medical, Surgical Sciences and Advanced Technologies, GF Ingrassia, University of Catania, Catania, Italy
| | - Alessandra Nicoletti
- Department of Medical, Surgical Sciences and Advanced Technologies, GF Ingrassia, University of Catania, Catania, Italy
| | - Mario Zappia
- Department of Medical, Surgical Sciences and Advanced Technologies, GF Ingrassia, University of Catania, Catania, Italy
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Nisticò V, Ilia N, Conte F, Broglia G, Sanguineti C, Lombardi F, Scaravaggi S, Mangiaterra L, Tedesco R, Gambini O, Priori A, Maravita A, Demartini B. Forearm bisection task suggests an alteration in body schema in patients with functional movement disorders (motor conversion disorders). J Psychosom Res 2024; 178:111610. [PMID: 38359638 DOI: 10.1016/j.jpsychores.2024.111610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 01/16/2024] [Accepted: 02/11/2024] [Indexed: 02/17/2024]
Abstract
OBJECTIVES To explore potential alterations of the Body Schema, the implicit sensorimotor representation of one's own body, in patients with Functional Movement Disorders (FMD, Motor Conversion Disorders), characterized by neurological symptoms of altered voluntary motor function that cannot be explained by typical medical conditions. This investigation is prompted by the potential dissociation from their reportedly intact sense of ownership. METHODS 10 FMD patients and 11 healthy controls (HC) underwent the Forearm Bisection Task, aimed at assessing perceived body metrics, which consists in asking the subject, blindfolded, to repeatedly point at the perceived middle point of their dominant forearm with the index finger of their contralateral hand, and a psychometric assessment for anxiety, depression, alexithymia, and tendency to dissociation. RESULTS FMD patients bisected their forearm more proximally (with an increased shift towards their elbow equal to 7.5%) with respect to HC; average bisection point was positively associated with anxiety levels in the whole sample, and with the tendency to dissociation in the FMD group. CONCLUSIONS FMD patients perceive their forearm as shorter than HC, suggesting an alteration of their Body Schema. The Body Schema can go through short- and long-term updates in the life course, mainly related to the use of each body segment; we speculate that, despite FMD being a disorder of functional nature, characterized by variability and fluctuations in symptomatology, the lack of sense of agency over a body part might be interpreted by the nervous system as disuse and hence influence the Body Schema, as deficits of organic etiology do.
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Affiliation(s)
- Veronica Nisticò
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milano, Italy; "Aldo Ravelli" Research Center for Neurotechnology and Experimental Brain Therapeutics, Università degli Studi di Milano, Milano, Italy; Dipartimento di Psicologia, Università degli Studi di Milano - Bicocca, Milano, Italy.
| | - Neofytos Ilia
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milano, Italy
| | - Francesca Conte
- Dipartimento di Psicologia, Università degli Studi di Milano - Bicocca, Milano, Italy
| | - Giovanni Broglia
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milano, Italy
| | - Claudio Sanguineti
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milano, Italy
| | - Francesco Lombardi
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milano, Italy
| | - Silvia Scaravaggi
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milano, Italy
| | - Laura Mangiaterra
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milano, Italy
| | - Roberta Tedesco
- Unità di Psichiatria, Servizio Psichiatrico di Diagnosi e Cura, Ospedale Civile di Legnano, ASST Ovest Milanese, Milano, Italy
| | - Orsola Gambini
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milano, Italy; "Aldo Ravelli" Research Center for Neurotechnology and Experimental Brain Therapeutics, Università degli Studi di Milano, Milano, Italy; Unità di Psichiatria 52, Presidio San Paolo, ASST Santi Paolo e Carlo, Milano, Italy
| | - Alberto Priori
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milano, Italy; "Aldo Ravelli" Research Center for Neurotechnology and Experimental Brain Therapeutics, Università degli Studi di Milano, Milano, Italy; III Clinica Neurologica, Presidio San Paolo, ASST Santi Paolo e Carlo, Milano, Italy
| | - Angelo Maravita
- Dipartimento di Psicologia, Università degli Studi di Milano - Bicocca, Milano, Italy
| | - Benedetta Demartini
- "Aldo Ravelli" Research Center for Neurotechnology and Experimental Brain Therapeutics, Università degli Studi di Milano, Milano, Italy; Unità di Psichiatria, Servizio Psichiatrico di Diagnosi e Cura, Ospedale Civile di Legnano, ASST Ovest Milanese, Milano, Italy
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Laufer I, Mizrahi D, Zuckerman I. Enhancing EEG-based attachment style prediction: unveiling the impact of feature domains. Front Psychol 2024; 15:1326791. [PMID: 38318079 PMCID: PMC10838989 DOI: 10.3389/fpsyg.2024.1326791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 01/04/2024] [Indexed: 02/07/2024] Open
Abstract
Introduction Attachment styles are crucial in human relationships and have been explored through neurophysiological responses and EEG data analysis. This study investigates the potential of EEG data in predicting and differentiating secure and insecure attachment styles, contributing to the understanding of the neural basis of interpersonal dynamics. Methods We engaged 27 participants in our study, employing an XGBoost classifier to analyze EEG data across various feature domains, including time-domain, complexity-based, and frequency-based attributes. Results The study found significant differences in the precision of attachment style prediction: a high precision rate of 96.18% for predicting insecure attachment, and a lower precision of 55.34% for secure attachment. Balanced accuracy metrics indicated an overall model accuracy of approximately 84.14%, taking into account dataset imbalances. Discussion These results highlight the challenges in using EEG patterns for attachment style prediction due to the complex nature of attachment insecurities. Individuals with heightened perceived insecurity predominantly aligned with the insecure attachment category, suggesting a link to their increased emotional reactivity and sensitivity to social cues. The study underscores the importance of time-domain features in prediction accuracy, followed by complexity-based features, while noting the lesser impact of frequency-based features. Our findings advance the understanding of the neural correlates of attachment and pave the way for future research, including expanding demographic diversity and integrating multimodal data to refine predictive models.
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Affiliation(s)
| | - Dor Mizrahi
- Department of Industrial Engineering and Management, Ariel University, Ariel, Israel
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Gilmour GS, Langer LK, Lang AE, MacGillivray L, Lidstone SC. Neuropsychiatric phenotypes in functional movement disorder. CNS Spectr 2023; 28:747-755. [PMID: 37424291 DOI: 10.1017/s1092852923002353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
OBJECTIVE Functional movement disorder (FMD), the motor-dominant subtype of functional neurological disorder, is a complex neuropsychiatric condition. Patients with FMD also manifest non-motor symptoms. Given that patients with FMD are diagnosed based on motor phenotype, the contribution of non-motor features to the neuropsychiatric syndrome is not well characterized. The objective of this hypothesis-generating study was to explore potential novel, neuropsychiatric FMD phenotypes by combining movement disorder presentations with non-motor comorbidities including somatic symptoms, psychiatric diagnoses, and psychological traits. METHODS This retrospective chart review evaluated 158 consecutive patients with a diagnosis of FMD who underwent deep phenotyping across neurological and psychiatric domains. Demographic, clinical, and self-report features were analyzed. A data-driven approach using cluster analysis was performed to detect patterns when combining the movement disorder presentation with somatic symptoms, psychiatric diagnoses, and psychological factors. These new neuropsychiatric FMD phenotypes were then tested using logistic regression models. RESULTS Distinct neuropsychiatric FMD phenotypes emerged when stratifying by episodic vs. constant motor symptoms. Episodic FMD was associated with hyperkinetic movements, hyperarousal, anxiety, and history of trauma. In contrast, constant FMD was associated with weakness, gait disorders, fixed dystonia, activity avoidance, and low self-agency. Pain, fatigue, somatic preoccupation, and health anxiety were common across all phenotypes. CONCLUSION This study found patterns spanning the neurological-psychiatric interface that indicate that FMD is part of a broader neuropsychiatric syndrome. Adopting a transdisciplinary view of illness reveals readily identifiable clinical factors that are relevant for the development and maintenance of FMD.
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Affiliation(s)
- Gabriela S Gilmour
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, ON, Canada
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Laura K Langer
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Anthony E Lang
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, ON, Canada
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Lindsey MacGillivray
- Integrated Movement Disorders Program, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Centre for Mental Health, University Health Network, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Sarah C Lidstone
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Integrated Movement Disorders Program, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
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Cuoco S, Scannapieco S, Carotenuto I, Picillo M, Pellecchia MT, Barone P, Erro R. Higher Health Service Costs Associated With Delayed Diagnosis of Functional Neurological Disorder. J Neuropsychiatry Clin Neurosci 2023; 35:86-91. [PMID: 35989570 DOI: 10.1176/appi.neuropsych.21110288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Functional neurological disorder (FND) is frequently encountered in clinical practice but commonly misdiagnosed, which might lead to higher direct costs for the health care system. The investigators analyzed the direct costs associated with the diagnosis of FND compared with costs associated with other neurological conditions and explored possible cost trends related to the clinical and demographic features of FND. METHODS Consecutive patients attending a general neurology clinic were recruited and underwent a structured assessment aimed to collect information pertaining to their demographic and clinical characteristics, as well as data regarding their prior diagnostic processes (e.g., the number of consulted specialists, number and type of investigations, emergency department visits, etc.). The costs were hence calculated and compared between the study groups. RESULTS A total of 155 consecutive patients were recruited; of these, 18.6% had FND, 55.84% had one or more other neurological disorder (OND), and 27.10% presented with comorbid FND and OND. The total prediagnostic costs (in euros [€]) were higher in the FND group compared with the OND group (median=€289, interquartile range [IQR] €385 vs. median=€98, IQR €216; Mann-Whitney U=879.5, p=0.04). There was a higher diagnostic delay in the FND group compared with the OND group (median=48 months, IQR 60 months vs. median=12 months, IQR 6 months; Mann-Whitney U=162.00, p<0.01). Diagnostic delay significantly correlated with the total costs in the entire study sample (Spearman's ρ=0.25, p=0.003) but more strongly in the FND group (Spearman's ρ=0.81, p<0.001). In the FND group, higher numbers of investigations and costs were associated with the presence of a physiological or psychological trigger and multiple symptoms. CONCLUSIONS Delayed diagnosis of FND significantly affects health care system costs, and raising awareness about FND to improve the diagnostic process and outcomes is necessary.
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Affiliation(s)
- Sofia Cuoco
- Department of Medicine, Surgery, and Dentistry "Scuola Medica Salernitana," Neuroscience Section, University of Salerno, Baronissi (SA), Italy (Cuoco, Scannapieco, Carotenuto, Picillo, Erro); Centro Malattie Neurodegenerative, University of Salerno, Baronissi (SA), Italy (Pellecchia, Barone)
| | - Sara Scannapieco
- Department of Medicine, Surgery, and Dentistry "Scuola Medica Salernitana," Neuroscience Section, University of Salerno, Baronissi (SA), Italy (Cuoco, Scannapieco, Carotenuto, Picillo, Erro); Centro Malattie Neurodegenerative, University of Salerno, Baronissi (SA), Italy (Pellecchia, Barone)
| | - Imma Carotenuto
- Department of Medicine, Surgery, and Dentistry "Scuola Medica Salernitana," Neuroscience Section, University of Salerno, Baronissi (SA), Italy (Cuoco, Scannapieco, Carotenuto, Picillo, Erro); Centro Malattie Neurodegenerative, University of Salerno, Baronissi (SA), Italy (Pellecchia, Barone)
| | - Marina Picillo
- Department of Medicine, Surgery, and Dentistry "Scuola Medica Salernitana," Neuroscience Section, University of Salerno, Baronissi (SA), Italy (Cuoco, Scannapieco, Carotenuto, Picillo, Erro); Centro Malattie Neurodegenerative, University of Salerno, Baronissi (SA), Italy (Pellecchia, Barone)
| | - Maria Teresa Pellecchia
- Department of Medicine, Surgery, and Dentistry "Scuola Medica Salernitana," Neuroscience Section, University of Salerno, Baronissi (SA), Italy (Cuoco, Scannapieco, Carotenuto, Picillo, Erro); Centro Malattie Neurodegenerative, University of Salerno, Baronissi (SA), Italy (Pellecchia, Barone)
| | - Paolo Barone
- Department of Medicine, Surgery, and Dentistry "Scuola Medica Salernitana," Neuroscience Section, University of Salerno, Baronissi (SA), Italy (Cuoco, Scannapieco, Carotenuto, Picillo, Erro); Centro Malattie Neurodegenerative, University of Salerno, Baronissi (SA), Italy (Pellecchia, Barone)
| | - Roberto Erro
- Department of Medicine, Surgery, and Dentistry "Scuola Medica Salernitana," Neuroscience Section, University of Salerno, Baronissi (SA), Italy (Cuoco, Scannapieco, Carotenuto, Picillo, Erro); Centro Malattie Neurodegenerative, University of Salerno, Baronissi (SA), Italy (Pellecchia, Barone)
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The effect of attachment style on long-term outcomes in psychogenic nonepileptic seizures: Results from a prospective study. Epilepsy Behav 2022; 135:108890. [PMID: 36037581 DOI: 10.1016/j.yebeh.2022.108890] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 08/16/2022] [Accepted: 08/16/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Insecure and fearful attachment styles have been reported in psychogenic nonepileptic seizures (PNES). We have investigated associations between long-term clinical outcome in PNES, parenting and attachment styles and demographic, clinical, and neuropsychiatric factors. MATERIAL AND METHODS Patients aged at least 16 years and with documented PNES, according to criteria from the International League Against Epilepsy, were prospectively recruited to this study. They were assessed at baseline to determine clinical characteristics, experience of attachment and perceptions of experienced parenting styles, trauma history, dissociation, and health-related quality of life. At a mean of 70.45 (SD 29.0, range 22-130) months after inclusion, participants were contacted by telephone and asked about their current medical status and psychiatric/psychological interventions. RESULTS Of 53 patients included in the study, 51 (96 %) provided follow-up data. Most (84.9 %) patients were female, and the mean age of PNES onset was 25.6 years. At follow-up, 20 patients (39 %) were free of PNES. Those patients that had achieved PNES freedom at follow-up had lower levels of attachment anxiety (p = 0.01) and reported to have experienced their fathers as less controlling (p = 0.02) and their mothers as more caring (p = 0.04) at baseline compared with those patients still suffering from PNES. Seizure freedom at follow-up was predicted by male gender, younger age at PNES onset, and less attachment anxiety. CONCLUSION In our cohort from a tertiary epilepsy center the long-term prognosis of PNES is poor. Attachment anxiety is a risk factor for persistent PNES. It may be of therapeutic relevance to assess attachment patterns in patients with PNES.
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Jungilligens J, Paredes-Echeverri S, Popkirov S, Barrett LF, Perez DL. A new science of emotion: implications for functional neurological disorder. Brain 2022; 145:2648-2663. [PMID: 35653495 PMCID: PMC9905015 DOI: 10.1093/brain/awac204] [Citation(s) in RCA: 61] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/28/2022] [Accepted: 05/20/2022] [Indexed: 01/11/2023] Open
Abstract
Functional neurological disorder reflects impairments in brain networks leading to distressing motor, sensory and/or cognitive symptoms that demonstrate positive clinical signs on examination incongruent with other conditions. A central issue in historical and contemporary formulations of functional neurological disorder has been the mechanistic and aetiological role of emotions. However, the debate has mostly omitted fundamental questions about the nature of emotions in the first place. In this perspective article, we first outline a set of relevant working principles of the brain (e.g. allostasis, predictive processing, interoception and affect), followed by a focused review of the theory of constructed emotion to introduce a new understanding of what emotions are. Building on this theoretical framework, we formulate how altered emotion category construction can be an integral component of the pathophysiology of functional neurological disorder and related functional somatic symptoms. In doing so, we address several themes for the functional neurological disorder field including: (i) how energy regulation and the process of emotion category construction relate to symptom generation, including revisiting alexithymia, 'panic attack without panic', dissociation, insecure attachment and the influential role of life experiences; (ii) re-interpret select neurobiological research findings in functional neurological disorder cohorts through the lens of the theory of constructed emotion to illustrate its potential mechanistic relevance; and (iii) discuss therapeutic implications. While we continue to support that functional neurological disorder is mechanistically and aetiologically heterogenous, consideration of how the theory of constructed emotion relates to the generation and maintenance of functional neurological and functional somatic symptoms offers an integrated viewpoint that cuts across neurology, psychiatry, psychology and cognitive-affective neuroscience.
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Affiliation(s)
- Johannes Jungilligens
- Correspondence to: Johannes Jungilligens University Hospital Knappschaftskrankenhaus Bochum Department of Neurology In der Schornau 23-25 44892 Bochum, Germany E-mail:
| | | | - Stoyan Popkirov
- Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, Bochum, Germany
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Paleari V, Nisticò V, Nardocci N, Canevini MP, Priori A, Gambini O, Zorzi G, Demartini B. Socio-demographic characteristics and psychopathological assessment in a sample of 13 paediatric patients with functional neurological disorders: A preliminary report. Clin Child Psychol Psychiatry 2022; 27:492-503. [PMID: 34743581 DOI: 10.1177/13591045211055084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This observational study aims to characterize, from a socio-demographic and psychopathological perspective, a sample of children with Functional Neurological Disorders (FND). Thirteen paediatric patients (below 18 years old) with FND and their parents completed a battery of anamnestic and neuropsychological tests, assessing socio-demographic status, cognitive level, behavioural and emotional issues, depression, anxiety, alexithymic traits and dissociative symptoms. Five patients presented movement disorders (tremor, myoclonus and gait disorder), three patients psychogenic non-epileptic seizures and five patients sensitivity disturbances (pain, anaesthesia and paraesthesia). Cognitive profile was normal in 11 patients; academic performance was good in nine patients, but three had a diagnosis of Specific Learning Difficulty or Attention Deficit Hyperactivity Disorder. Precipitating events occurred in 11 patients. At the self-report questionnaires, mean scores close to the clinical cut off were documented with respect to affective and somatic problems. At the parent-report questionnaires, clinically significant mean scores were observed in the subscales assessing anxious-depressive symptoms and somatic complaints. We speculate that paediatric FND patients, although acknowledging the relevance of somatic symptoms, have difficulties in recognizing internal emotional states (that, instead, are easily recognized by their parents). The case of one FND patient was described. These preliminary data might help identifying different clinical phenotypes of paediatric FND.
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Affiliation(s)
- Vittoria Paleari
- Dipartimento di Scienze Della Salute, Università Degli Studi di Milano, Milano, Italy.,U.O. Neuropsichiatria Infantile Fondazione IRCCS, 9328Istituto Neurologico Carlo Besta, Milano, Italia
| | - Veronica Nisticò
- Dipartimento di Scienze Della Salute, Università Degli Studi di Milano, Milano, Italy.,"Aldo Ravelli" Research Center for Neurotechnology and Experimental Brain Therapeutics, Università Degli Studi di Milano, Milano, Italy
| | - Nardo Nardocci
- U.O. Neuropsichiatria Infantile Fondazione IRCCS, 9328Istituto Neurologico Carlo Besta, Milano, Italia
| | - Maria Paola Canevini
- U.O. Neuropsichiatria Infantile ASST Santi Paolo e Carlo, Presidio San Paolo, Milano, Italy
| | - Alberto Priori
- Dipartimento di Scienze Della Salute, Università Degli Studi di Milano, Milano, Italy.,"Aldo Ravelli" Research Center for Neurotechnology and Experimental Brain Therapeutics, Università Degli Studi di Milano, Milano, Italy.,III Clinica Neurologica, ASST Santi Paolo e Carlo, Presidio San Paolo, Milano, Italy
| | - Orsola Gambini
- Dipartimento di Scienze Della Salute, Università Degli Studi di Milano, Milano, Italy.,"Aldo Ravelli" Research Center for Neurotechnology and Experimental Brain Therapeutics, Università Degli Studi di Milano, Milano, Italy.,Unità di Psichiatria 52, ASST Santi Paolo e Carlo, Presidio San Paolo, Milano, Italy
| | - Giovanna Zorzi
- U.O. Neuropsichiatria Infantile Fondazione IRCCS, 9328Istituto Neurologico Carlo Besta, Milano, Italia
| | - Benedetta Demartini
- Dipartimento di Scienze Della Salute, Università Degli Studi di Milano, Milano, Italy.,"Aldo Ravelli" Research Center for Neurotechnology and Experimental Brain Therapeutics, Università Degli Studi di Milano, Milano, Italy.,Unità di Psichiatria 52, ASST Santi Paolo e Carlo, Presidio San Paolo, Milano, Italy
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Krámská L, Hrešková L, Krámský D, Vojtěch Z. Attachment style of patients diagnosed with psychogenic non-epileptic seizures at a tertiary Epilepsy Center in the Czech Republic. Front Psychiatry 2022; 13:1065201. [PMID: 36465292 PMCID: PMC9712441 DOI: 10.3389/fpsyt.2022.1065201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 11/01/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Quality and type of early relationships with primary caregivers is considered one of the key factors in the etiopathogenesis of many mental disorders including depression, anxiety, and conversion disorders. This study focused on the type and quality of attachment style in adult patients with psychogenic non-epileptic seizures (PNES). MATERIALS AND METHODS We evaluated the demographic data and profiles of PNES patients (n = 262) and group of healthy volunteers (n = 51) measured by the Parental Bonding Inventory (PBI) and Experiences in Close Relationships (ECR) and Experiences in Close Relationships-Relationship Structure (ECR-RS). RESULTS Significant differences in measured values between the two groups were identified; specifically, differences in the caregiver style-father and mother overprotection (PBI) was higher in the PNES group. The most frequent type of attachment in PNES was type 2 (preoccupied). Correlations between the PBI and ECR results were also found. CONCLUSION This study highlighted certain attachment styles in patients with PNES and statistically significant differences between patients with PNES and a healthy sample. Some correlations between the results of the questionnaires with socio-demographic factors were found. The identification of specific patterns in attachment may be useful for further use in reaching a differential diagnosis and administering tailored psychotherapy of patients with PNES.
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Affiliation(s)
- Lenka Krámská
- Department of Clinical Psychology, Na Homolce Hospital, Prague, Czechia.,Epilepsy Center, Na Homolce Hospital, Prague, Czechia
| | - Lucia Hrešková
- Kúpele pre dušu, s.r.o., Bardejov Spa, Bardejov, Slovakia
| | - David Krámský
- Department of Social Science, Police Academy, Prague, Czechia
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