Psychogenic non-epileptic seizures: so-called psychiatric comorbidity and underlying defense mechanisms

Massimiliano Beghi,1,2 Paola Beffa Negrini,1 Cecilia Perin,1,3 Federica Peroni,1,3 Adriana Magaudda,4 Cesare Cerri,1,3 Cesare Maria Cornaggia1,3 1Department of Surgery and Translational Medicine, University of Milano-Bicocca, 2Department of Mental Health, “Guido Salvini” Hospital...

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Autores principales:	Beghi M, Beffa Negrini P, Perin C, Peroni F, Magaudda A, Cerri C, Cornaggia CM
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2015
Materias:	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/6cf2cf8f3ed34829ba25f7613ddcaca5
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spelling	oai:doaj.org-article:6cf2cf8f3ed34829ba25f7613ddcaca52021-12-02T04:45:15ZPsychogenic non-epileptic seizures: so-called psychiatric comorbidity and underlying defense mechanisms1178-2021https://doaj.org/article/6cf2cf8f3ed34829ba25f7613ddcaca52015-09-01T00:00:00Zhttps://www.dovepress.com/psychogenic-non-epileptic-seizures-so-called-psychiatric-comorbidity-a-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Massimiliano Beghi,1,2 Paola Beffa Negrini,1 Cecilia Perin,1,3 Federica Peroni,1,3 Adriana Magaudda,4 Cesare Cerri,1,3 Cesare Maria Cornaggia1,3 1Department of Surgery and Translational Medicine, University of Milano-Bicocca, 2Department of Mental Health, “Guido Salvini” Hospital, Garbagnate Milanese, Milan, Italy; 3Rehabilitation Medicine, Istituti Clinici Zucchi, Carate Brianza, Monza and Brianza, Italy; 4Epilepsy Center, Department of Neuroscience, University of Messina, Messina, Italy Abstract: 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. Keywords: epilepsy, PNES, defense mechanisms, comorbidityBeghi MBeffa Negrini PPerin CPeroni FMagaudda ACerri CCornaggia CMDove Medical PressarticleNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol 2015, Iss default, Pp 2519-2527 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Beghi M Beffa Negrini P Perin C Peroni F Magaudda A Cerri C Cornaggia CM Psychogenic non-epileptic seizures: so-called psychiatric comorbidity and underlying defense mechanisms
description	Massimiliano Beghi,1,2 Paola Beffa Negrini,1 Cecilia Perin,1,3 Federica Peroni,1,3 Adriana Magaudda,4 Cesare Cerri,1,3 Cesare Maria Cornaggia1,3 1Department of Surgery and Translational Medicine, University of Milano-Bicocca, 2Department of Mental Health, “Guido Salvini” Hospital, Garbagnate Milanese, Milan, Italy; 3Rehabilitation Medicine, Istituti Clinici Zucchi, Carate Brianza, Monza and Brianza, Italy; 4Epilepsy Center, Department of Neuroscience, University of Messina, Messina, Italy Abstract: 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. Keywords: epilepsy, PNES, defense mechanisms, comorbidity
format	article
author	Beghi M Beffa Negrini P Perin C Peroni F Magaudda A Cerri C Cornaggia CM
author_facet	Beghi M Beffa Negrini P Perin C Peroni F Magaudda A Cerri C Cornaggia CM
author_sort	Beghi M
title	Psychogenic non-epileptic seizures: so-called psychiatric comorbidity and underlying defense mechanisms
title_short	Psychogenic non-epileptic seizures: so-called psychiatric comorbidity and underlying defense mechanisms
title_full	Psychogenic non-epileptic seizures: so-called psychiatric comorbidity and underlying defense mechanisms
title_fullStr	Psychogenic non-epileptic seizures: so-called psychiatric comorbidity and underlying defense mechanisms
title_full_unstemmed	Psychogenic non-epileptic seizures: so-called psychiatric comorbidity and underlying defense mechanisms
title_sort	psychogenic non-epileptic seizures: so-called psychiatric comorbidity and underlying defense mechanisms
publisher	Dove Medical Press
publishDate	2015
url	https://doaj.org/article/6cf2cf8f3ed34829ba25f7613ddcaca5
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Psychogenic non-epileptic seizures: so-called psychiatric comorbidity and underlying defense mechanisms

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