The association of sexual and physical abuse with 
somatization: characteristics of patients presenting 
with irritable bowel syndrome and non-epileptic 
attack disorder

Reilly, Jacqueline; Baker, Gus A.; Rhodes, Jonathan M.; Salmon, Peter

doi:10.1017/s0033291798007892

Cited by 89 publications

(76 citation statements)

References 28 publications

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“…26 Moreover, as in other dissociative disorders, physical or sexual abuse and other traumatizing events are common among individuals with PNES. 27 In this view, symptoms and signs are strictly consequential to a (psychological) trauma, there being often a detachment from reality with or without alterations in personal identity or sense of self. However, other researchers have emphasized the overlap between psychogenic neurologic symptoms and anxiety rather than dissociation, 28 supporting the hypothesis that they could represent somatizations.…”

Section: Diagnostic Criteria and Categories Of Diagnostic Certaintymentioning

confidence: 99%

Psychogenic nonepileptic seizures and movement disorders

et al. 2016

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Purpose of review: Neurologic symptoms due to a psychogenic cause are frequently seen in clinical practice. Psychogenic nonepileptic seizures (PNES) and psychogenic movement disorders (PMD) are among the most common psychogenic neurologic disorders. PNES and PMD are usually investigated and managed separately by different neurology subspecialists. We review the main epidemiologic and clinical features of both PNES and PMD, aiming to highlight their similarities and differences and to see whether a common framework for these disorders exists. Recent findings:Data from the literature show that there is a profound overlap between PNES and PMD, which would argue for a larger unifying pathophysiology with variable phenotypic manifestations. Summary: Collaborative and integrated research among epileptologists, movement disorders experts, psychiatrists, psychologists, and physiotherapists may increase our collective knowledge about the pathophysiologic mechanisms of PNES and PMD and therefore improve outcomes for these patients. Neurol Clin Pract 2016;6:138-149 N eurologic symptoms due to a functional or psychogenic cause are common in clinical practice, accounting for up to 16% of patients presenting to neurology outpatient clinics, depending on the clinical definitions and methodology used for case ascertainment.1,2 The yearly costs of patients with medically unexplained symptoms in the United States have been estimated at approximately $256 billion per year.3 Despite their prevalence and associated economic and social burden, appropriate treatments for these disorders are an unmet need. This may reflect the absence of research interest and lack of discourse between neurology and psychiatry regarding these patients. Notably, although approximately 50% of the patients with somatoform disorders are identified by neurologists at the time of first contact, only 1.5% are referred to a psychiatrist or a psychologist.

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Section: Diagnostic Criteria and Categories Of Diagnostic Certaintymentioning

confidence: 99%

Psychogenic nonepileptic seizures and movement disorders

et al. 2016

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“…It is possible that antecedent traumatic psychological experiences may play an etiologic role in the persistence of symptoms after the infection has been adequately treated (20). This relationship has been demonstrated in other MUS conditions, including multiple chemical sensitivity (21), chronic fatigue syndrome, (22), irritable bowel syndrome (23)(24)(25)(26), chronic pelvic pain (27), and fibromyalgia (28)(29)(30).…”

Section: Lyme Disease Medically Unexplained Syndromes and The Anxiomentioning

confidence: 96%

Contributions of societal and geographical environments to "chronic Lyme disease": the psychopathogenesis and aporology of a new "medically unexplained symptoms" syndrome.

Sigal¹,

Hassett²

2002

Environ Health Perspect

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Lyme disease is a relatively well-described infectious disease with multisystem manifestations. Because of confusion over conflicting reports, anxiety related to vulnerability to disease, and sensationalized and inaccurate lay media coverage, a new syndrome, "chronic Lyme disease," has become established. Chronic Lyme disease is the most recent in a continuing series of "medically unexplained symptoms" syndromes. These syndromes, such as fibromyalgia, chronic fatigue syndrome, and multiple chemical sensitivity, meet the need for a societally and morally acceptable explanation for ill-defined symptoms in the absence of objective physical and laboratory findings. We describe factors involved in the psychopathogenesis of chronic Lyme disease and focus on the confusion and insecurity these patients feel, which gives rise to an inability to adequately formulate and articulate their health concerns and to deal adequately with their medical needs, a state of disorganization termed aporia. Key words: aporology, chronic Lyme disease, Lyme disease, medically unexplained symptoms, misdiagnosis, psychological, psychopathogenesis.

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“…In PNES, psychological conflicts are translated into a physical symptom, the seizure. In this way, intolerable distress is dissociated from the painful conscious experience of the trauma or forbidden emotions causing the distress [31] [32]. Thus genuine PNES (as opposed to factitious disorder or malingering) are necessarily not intentional; they are created as a psychological defense mechanism to keep the internal stressors out of conscious awareness [31].…”

Section: Etiologymentioning

confidence: 99%

“…More recently, Dikel et al [39] found significantly higher rates of PTSD, childhood sexual abuse, dissociative symptoms and history of assaultive trauma in patients with PNES compared to epileptic controls. Physical and sexual abuse have been linked to increased rates of several somatization syndromes, including PNES [32].…”

Section: Etiologymentioning

confidence: 99%

Psychogenic Nonepileptic Seizures: What a Neurologist Should Know

Alsaadi¹,

Shahrour²

2014

Health

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Psychogenic nonepileptic seizures (PNES) are episodes of movement, sensation or behavior changes similar to epileptic seizures but without neurological origin. They are somatic manifestations of psychological distress. The aim of this article is to provide a comprehensive review of the practical aspects of this, most often misdiagnosed disorder, which will be of clinical relevance to all practicing neurologists. Patients with PNES are often misdiagnosed and treated for epilepsy for years, resulting in significant morbidity. Video-EEG monitoring is the gold standard for diagnosis. Five to ten percent of outpatient epilepsy populations and 20 to 40 percent of inpatient and specialty epilepsy center patients have PNES. These patients inevitably have comorbid psychiatric illnesses, most commonly depression, post-traumatic stress disorder (PTSD), other dissociative and somatoform disorders, and personality pathology, especially borderline type. Many have a history of sexual and physical abuse. 75 to 85 percent of patients with PNES are women. Although PNES can occur at any age, they typically begin in young adulthood. Treatment involves discontinuing antiepileptic drugs in patients without concurrent epilepsy and referring for appropriate psychiatric care. Additional larger controlled studies to determine the best treatment modalities are needed.

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The association of sexual and physical abuse with somatization: characteristics of patients presenting with irritable bowel syndrome and non-epileptic attack disorder

Cited by 89 publications

References 28 publications

Psychogenic nonepileptic seizures and movement disorders

Psychogenic nonepileptic seizures and movement disorders

Contributions of societal and geographical environments to "chronic Lyme disease": the psychopathogenesis and aporology of a new "medically unexplained symptoms" syndrome.

Psychogenic Nonepileptic Seizures: What a Neurologist Should Know

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