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2015 ; 11
(ä): 2519-27
Nephropedia Template TP
Beghi M
; Negrini PB
; Perin C
; Peroni F
; Magaudda A
; Cerri C
; Cornaggia CM
Neuropsychiatr Dis Treat
2015[]; 11
(ä): 2519-27
PMID26491330
show ga
In Diagnostic and Statistical Manual of Mental Disorders, fifth edition,
psychogenic non-epileptic seizures (PNES) do not have a unique classification as
they can be found within different categories: conversion, dissociative, and
somatization disorders. The ICD-10, instead, considers PNES within dissociative
disorders, merging the dissociative disorders and conversion disorders, although
the underlying defense mechanisms are different. The literature data show that
PNES are associated with cluster B (mainly borderline) personality disorders
and/or to people with depressive or anxiety disorders. Defense mechanisms in
patients with PNES with a prevalence of anxious/depressive symptoms are of
"neurotic" type; their goal is to lead to a "split", either vertical
(dissociation) or horizontal (repression). The majority of patients with this
type of PNES have alexithymia traits, meaning that they had difficulties in
feeling or perceiving emotions. In subjects where PNES are associated with a
borderline personality, in which the symbolic function is lost, the defense
mechanisms are of a more archaic nature (denial). PNES with different underlying
defense mechanisms have different prognoses (despite similar severity of PNES)
and need usually a different treatment (pharmacological or psychological). Thus,
it appears superfluous to talk about psychiatric comorbidity, since PNES are a
different symptomatic expression of specific psychiatric disorders.