Psikojenik Nöbet Tipinde Konversiyon Bozukluğu Olan Ergenlerde Çocukluk Çağı Travmaları, Bağlanma ve Aleksitimi

Abstract

In this cross-sectional study, adolescents with psychogenic nonepileptic seizures (PNES) were compared with adolescents without any psychiatric disorder using both semi-structured clinical interviews and self-report scales for variables that are thought to be related to PNES. In this respect, childhood traumas, attachment security, alexithymia, self-image and self-esteem were examined. In addition, comorbid psychopathologies in adolescents with PNES were evaluated. Forty-two adolescents with PNES aged between 12-18 and 38 healthy adolescents who were matched with the study group in respect to age, gender and socioeconomic status were participated. All adolescents and their parents were interviwed using Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL) in order to evaluate psychiatric disorders. Clinician-Administered PTSD Scale for Children and Adolescents (CAPS-CA) was used to examine the presence of symptoms of posttraumatic stress disorder. All adolescents completed the Childhood Trauma Questionnaire-28 (CTQ-28), Short Form of Inventory of Parent and Peer Attachment (IPPA), Toronto Alexithymia Scale, Offer Self Image Questionnaire and Rosenberg Self Esteem Scale. Clinical Global Impressions Scale was used to determine the severity of symptoms in adolescents with PNES. PNES was more common in females with middle and lower-middle socioeconomic status. In the PNES group, the family history of psychiatric disorder was higher than the control group and a stress factor usually accompanied the emergence of the symptoms. Somatoform disorders other than PNES were the most common comorbid psychiatric disorders in the PNES group. Adolescents with PNES had more emotional and sexual traumatic experiences compared to the control group. PNES group perceived higher “communication” but lower “trust” in attachment relationships with their mothers and fathers. More alexithymia and less self-esteem were determined in the PNES group. Childhood traumas and alexithymia were found v to be significant risk factors for PNES. The results of this study suggest that childhood traumas and alexithymia may have a role in the development of PNES type of conversion disorder in adolescents. In addition to traumatic experiences and alexithymia, attachment security and self-esteem need to be evaluated in these patients. In order to determine the specificity of these results, studies including adolescents with other psychiatric disorders as control groups are required.