首页> 外文期刊>Journal of Neurology, Neurosurgery and Psychiatry >Characteristics of patients with persistent severe disability and medically unexplained neurological symptoms: a pilot study.
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Characteristics of patients with persistent severe disability and medically unexplained neurological symptoms: a pilot study.

机译:持续严重残疾和医学上无法解释的神经系统症状患者的特征:一项前瞻性研究。

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摘要

This study audited 25 patients (21 female) from Oxfordshire who had been referred to either the liaison psychiatry or the neurological disability service between 1992 and 1998, reported a Barthel activities of daily living index score < 20 or a global assessment of functioning score of < or = 30, and had no pathology to explain their neurological disability. Levels of motor impairment, disability, mood, and cognitive status were assessed using standardised scales, and all patients were assigned a psychiatric diagnosis according to the International classification of diseases, 10th revision. Of the 25 patients, 13 had a motor conversion disorder, 8 had diverse somatoform disorders, and 3 had chronic fatigue syndrome. Nine had extensive previous contact with psychiatric services and 11 had experienced physical or sexual abuse. In 6 patients cessation of repeated self harm was closely associated with the onset of wheelchair use. Seven were receiving treatment for depression. The commonest putative diagnoses were multiple sclerosis (6) and epilepsy (5). Twelve were unable to walk and 20 owned a wheelchair but only 3 had formal care packages. The mean (SD) Barthel score was 14.1 (3.3) and the mean (SD) Frenchay activity index score was 12.9 (7.5). All were unemployed and receiving a disability living allowance, and some had benefits of up to pound 1815 a month. This small but significant group of disabled patients had a variety of psychiatric and neurological diagnoses and used considerable health care resources.
机译:这项研究审核了牛津郡的25例患者(21例女性),这些患者在1992年至1998年之间被转介到联络精神病学或神经残疾服务部门,报告了Barthel活动的日常生活指数评分<20或整体功能评分或= 30,并且没有病理学可以解释其神经功能障碍。使用标准化量表评估运动障碍,残疾,情绪和认知状态的水平,并根据国际疾病分类(第10版)对所有患者进行精神病学诊断。在25例患者中,有13例患有运动转换障碍,8例患有多种躯体形式障碍,3例患有慢性疲劳综合征。先前有9位曾与精神科服务机构广泛接触,另有11位曾遭受身体或性虐待。在6例患者中,反复自我伤害的停止与轮椅使用的开始密切相关。七个正在接受抑郁症治疗。最常见的诊断是多发性硬化症(6)和癫痫病(5)。有十二人无法走路,有二十人没有轮椅,但只有三人拥有正式的护理包。 Barthel评分的平均(SD)为14.1(3.3),Frenchay活动指数的平均值(SD)为12.9(7.5)。所有这些人都失业,并领取残疾生活津贴,有些人每月可获得的最高补助为1815英镑。这一小而重要的残疾患者群体具有各种精神病学和神经病学诊断,并使用了大量的医疗保健资源。

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