功能性运动障碍患者之间持续的诊断分歧
Adriano Mollica1,2, Nima Nahiddi3, Gabriela S Gilmour4,5
1Neuropsychiatry Program, Department of Psychiatry, Sunnybrook Health Sciences Center, University of Toronto, Toronto.
概括
持续的诊断分歧 (PDD) 在功能运动障碍 (FMD) 中很常见,并且与心理因素有关. 本研究定义了PDD,并确定了口病患者的相关因素,突出了潜在的干预领域.
科学领域:
- 神经学 神经学
- 精神病学是一个精神病学.
- 临床心理学 临床心理学
背景情况:
- 诊断协议对于神经系统疾病的有效治疗结果至关重要.
- 功能性运动障碍 (FMD) 中的持续诊断不一致 (PDD) 尚未得到充分研究.
- 了解PDD对于改善患者护理和治疗 FMD 成功至关重要.
研究的目的:
- 建议在功能性运动障碍 (FMD) 中对持续的诊断分歧 (PDD) 提出定义.
- 确定与口病患者PDD相关的人口和临床因素.
- 评估患者自我报告的准确性和临床医生的印象,以确定PDD.
主要方法:
- 从158名口病患者的临床数据的回顾性审查.
- 评估患者自我报告的诊断协议和专家确定的PDD状态.
- 利用后勤回归和LASSO建模来识别与PDD相关的因素.
- 推临床医生的印象和患者的自我报告之间的评估一致性.
主要成果:
- 41%的口炎患者 (116人中有47人) 被归类为患有PDD.
- 后期发育障碍与低代理,B集群特征,较低的变化准备度和无法注意到症状变异性有关.
- 低影响力是LASSO分析中保留的唯一因素.
- 转诊医生的印象与患者自我报告的不同意见之间的一致性很低 (加权 κ=0.21).
结论:
- 持续的诊断分歧在功能运动障碍中很普遍.
- 无论是患者的自我报告还是最初的临床印象都不能准确地确定PDD.
- PDD可能与可修改的心理过程有关,这表明潜在的治疗点.
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