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Title: Forming the process of differential neuropsychological diagnosis of psychogenic and organic disorders in children

Abstract:

Introduction. Psychogenic nonepileptic seizures constitute 15-40% of all cases directed to specialized epileptology diagnostic centers. The golden standard of the diagnosis consists of a videoEEG assessment, which doesn’t always provide unequivocal results. At present we lack a psychological diagnostic standard, as well as treatment standards. Depending on various factors, the prognosis in up to 60% of patients is pessimistic, with around 25% becoming chronically ill, and 7,7 years being the medium time-course of the disease. Goal of the study. Our final goal was to prepare a basis for the standards of the differential psychological diagnosis of psychogenic seizures and organic symptoms in children („golden standard”). Material. We examined altogether 63 children, of which 50 patients (aged 11,3-17,11; 20 with psychogenic seizures and 30 with tension headache) underwent a cycle of short-term cognitive-behavioral psychotherapy. Methods. All children were examined using a psychological interview based on techniques acquired from forensic psychology and cognitive-behavioral psychotherapy approaches, an extensive neuropsychological assessment (age appropriate Wechsler and/or Raven intelligence scales; the Rey 15 Words Learning Test; ‘Zeszyty Łuckiego’ – a set of clinical trials fo neuropsychological assessment of memory, praxis and executive functioning; Rey Complex Figure Test; DUM test for the assessment of visual learning; D2 test assessing attention; verbal fluency trials), emotional functioning assessment (‘Jaki jesteś?’ an anxiety questionnaire by Chojnowski and Skrzypek, EPQR Eysenck personality questionnaire; Thematic Apperception test, Test Zdań Niedokończonych – an open question assessment method). Cognitive-behavioral psychotherapy was the treatment method used in this research. An evoked potential analysis (P300) was used in search of neurophysiological differences between various types of psychogenic disorders. Results. No statistically significant differences were found in the neurophysiological examination between children with various types of psychogenic disorders. The neurophysiological examination, as a tool on its own, appears to be insufficient for the differential diagnosis of psychogenic and epileptic seizures in children. Assessment of the children’s general intelligence and psychological defense mechanisms in addition to a precisely conducted psychological interview is a much more effective tool. Cognitive behavioral psychotherapy appears to be an effective way of treatment both in case of tension headaches and psychogenic nonepileptic seizures. Conclusions. The parameters of emotional functioning, as measured by questionnaires do differentiate patients with psychogenic disorders from the general population. The parameters of the P300 evoked potential do differ, but below statistically relevant level in children with various types of psychogenic disorders. Cognitive behavioral therapy is a promising treatment method of both psychogenic seizure disorder and tension headache.

Place of publishing:

Kraków

Level of degree:

2 - studia doktoranckie

Degree discipline:

psychologia ; neurologia ; pediatria

Degree grantor:

Uniwersytet Jagielloński. Collegium Medicum. Wydział Lekarski.

Promoter:

Marek Kaciński

Date issued:

2019

Format:

application/pdf

Identifier:

oai:dl.cm-uj.krakow.pl:4404

Call number:

ZB-132216

Access rights:

tylko w bibliotece

Location of original object:

Biblioteka Medyczna Uniwersytetu Jagiellońskiego- Collegium Medicum

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Last modified:

Mar 17, 2021

In our library since:

Mar 17, 2021

Number of object content hits:

1

All available object's versions:

http://dl.cm-uj.krakow.pl:8080/publication/4405

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ZB-132216 Mar 17, 2021
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