RATIONALE: Patients who experience seizures, including PNES, are usually advised to discontinue driving, or have their driving privileges revoked until a determined period of seizure-freedom is achieved. In this retrospective study, patients with PNES who requested driving privileges or reported having resumed driving were compared to those who did not on measures of depression, anxiety, PTSD, and cognitive flexibility/motor speed. METHODS: DiagnosisofPNESwasconfirmedwithvideo-EEG.Demographicand clinical dataand requests for reinstatement of driving privileges (requiring 6 or more months seizure freedom) and reports of decisions to resume driving were noted. Tests of motor speed and hand eye coordination and self-report questionnaires of depression, anxiety and PTSD administered as part of neuropsychological assessment were analyzed. RESULTS: A total of 403 patients with PNES evaluated in 2010-2020 were identified. Of those, 365 patients were eligible for inclusion, and of those, 60 applied for driving privileges or reported that they resumed driving. When the two groups were compared, the group that applied for driving privileges or decided to resume driving was significantly less depressed (p = 0.001) when tested than the group that did not. Furthermore, a significant difference was seen in measures of motor performance between those who requested to resume driving and those who did not (DKEFS T1, p = 0.006, DKEFS T2, p = 0.001, DKEFS T3, p = 0.002, DKEFS T4, p = 0.001; GPT dominant, p = 0.05, GPT non-dominant, p = 0.003). CONCLUSION: Driving a motor vehicle is a useful measure of improvement for PNES because patients with seizures are required to discontinue driving until seizure-freedom is achieved. This study revealed that lower levels of depression and better fine motor functioning were associated with reported seizure-freedom and driving resumption. Depression is commonly associated with diminished performance (slower motor response times and impaired fine motor movements) on tests of motor functioning, both of which may result in less interest in pursuing permission to resume driving. These findings suggest that mood symptoms (and associated performance on measures of motor speed and coordination) may have prognostic significance in patients diagnosed with PNES. This also suggests that timely treatment of depression in newly diagnosed patients with PNES may be indicated.
- MeSH
- Depression psychology diagnosis etiology MeSH
- Adult MeSH
- Electroencephalography MeSH
- Conversion Disorder psychology diagnosis MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Neuropsychological Tests MeSH
- Stress Disorders, Post-Traumatic psychology diagnosis MeSH
- Psychomotor Performance physiology MeSH
- Psychophysiologic Disorders diagnosis psychology MeSH
- Retrospective Studies MeSH
- Automobile Driving * psychology MeSH
- Anxiety psychology etiology diagnosis MeSH
- Seizures * psychology diagnosis MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- MeSH
- Humans MeSH
- Mind-Body Therapies methods MeSH
- Psychophysiologic Disorders diagnosis psychology therapy MeSH
- Somatoform Disorders * diagnosis psychology therapy MeSH
- Patient Care Team MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
- Keywords
- psychodermatologie, dermatopsychologie,
- MeSH
- Acne Vulgaris * etiology complications psychology therapy MeSH
- Chronic Disease psychology therapy MeSH
- Depression etiology therapy MeSH
- Comprehensive Health Care MeSH
- Humans MeSH
- Stress, Psychological * etiology complications therapy MeSH
- Mind-Body Therapies methods MeSH
- Psychophysiologic Disorders diagnosis etiology physiopathology psychology therapy MeSH
- Practice Guidelines as Topic MeSH
- Anxiety etiology therapy MeSH
- Check Tag
- Humans MeSH
Doporučené postupy pro praktické lékaře
První vydání 29 stran : barevné ilustrace ; 30 cm
Směrnice, které se zaměřují na diagnostiku a léčbu psychosomatických poruch. Určeno praktickým lékařům.
- MeSH
- Medically Unexplained Symptoms MeSH
- General Practice MeSH
- Mind-Body Therapies MeSH
- Psychosomatic Medicine MeSH
- Psychophysiologic Disorders diagnosis therapy MeSH
- Publication type
- Handbook MeSH
- Practice Guideline MeSH
- Conspectus
- Patologie. Klinická medicína
- NML Fields
- všeobecné lékařství
- psychologie, klinická psychologie
Psychosomatická medicína prošla v Česku v posledních letech dynamickým vývojem. V roce 2014 došlo k založení Společnosti psychosomatické medicíny ČLS JEP. Ta rozvíjí jak odbornou stránku tohoto oboru, tak usiluje o lepší integraci psychosomatické péče do systému českého zdravotnictví. Po několikaletém úsilí se jí podařilo docílit schválení kódu lékařského výkonu v oboru psychosomatika (909) „psychosomatická intervence“. Text „Doporučených diagnostických a terapeutických postupů psychosomatické péče“ popisuje doporučený pohyb psychosomatického pacienta v systému zdravotní péče, diagnostické kategorie v oblasti psychosomatické medicíny a s ní související diferenciální diagnostiku a základní diagnostické jednotky v oblasti psychosomatiky.
Psychosomatic medicine has undergone dynamic development in the Czech Republic in recent years. The Society of Psychosomatic Medicine of the Czech Medical Association of J. E. Purkyně was founded in 2014. It develops both the professional side of this field and strives for better integration of psychosomatic care into the Czech health care system. After several years of effort, it succeeded in obtaining approval of the medical procedure code in the field of psychosomatics (909) "psychosomatic intervention". The text of Recommended Diagnostic and Therapeutic Procedures for Psychosomatic Care describes the recommended movement of the psychosomatic patient through the health care system, diagnostic categories in psychosomatic medicine and related differential diagnosis, and basic diagnostic units in psychosomatic medicine.
- Keywords
- porucha tělesné úzkosti,
- MeSH
- Diagnosis, Differential MeSH
- Humans MeSH
- Psychosomatic Medicine MeSH
- Psychophysiologic Disorders * diagnosis MeSH
- Check Tag
- Humans MeSH
- Publication type
- Practice Guideline MeSH
Pacienti s medicínsky nevysvětlenými příznaky tvoří významnou část pacientů v ordinacích praktických lékařů a pro lékaře i pro celý zdravotně-sociální systém mohou být velmi zatěžující. V tomto přehledu autoři shrnují nejdůležitější současné poznatky o výskytu, příčinách a mechanismech vzniku tělesných potíží bez organické příčiny, charakteristikách pacientů s těmito potížemi a jejich prognóze. Dále se autoři zaměřují na možnosti diagnostiky a terapie těchto pacientů, zvláště na intervence uplatnitelné v primární péči. Nakonec diskutují tuto problematiku v českém kontextu, představují svůj výzkumný záměr a vybízejí ke změnám, které by vedly ke zlepšení péče o pacienty s medicínsky nevysvětlenými příznaky.
Patients with medically unexplained symptoms make up a significant proportion of patients in general practice and can be very burdensome for doctors and the whole health and social care system. In this review, the authors summarize the most important current knowledge about the incidence, causes, and mechanisms of physical complaints without an organic cause, the characteristics of patients with these complaints, and their prognosis. In addition, the authors focus on the diagnostic and therapeutic options for these patients, particularly interventions applicable in primary care. Finally, they discuss this issue in the Czech context, present their research agenda and call for changes that would lead to improved care of patients with medically unexplained symptoms.
- Keywords
- psychosomatická péče,
- MeSH
- Humans MeSH
- Disease Management MeSH
- Primary Health Care MeSH
- Psychophysiologic Disorders * diagnosis therapy MeSH
- Somatoform Disorders * diagnosis therapy MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
- MeSH
- Humans MeSH
- Brain surgery MeSH
- Neurosurgical Procedures psychology MeSH
- Neuropsychology MeSH
- Psychological Trauma MeSH
- Psychophysiologic Disorders diagnosis MeSH
- Psychotherapy MeSH
- Check Tag
- Humans MeSH
- Publication type
- Popular Work MeSH
- Interview MeSH
