Diagnosis, management and prognosis of a group of 128 patients with non-epileptic attack disorder. Part II. Previous childhood sexual abuse in the aetiology of these disorders.
In a group of female in-patients clinically diagnosed as having non-epileptic attack disorder there was an increased incidence of a proven previous history of sexual abuse in childhood, when compared with a group of women with epilepsy and a group of women with other psychiatric disorders admitted to the same ward. This was particularly true of women with the 'swoon' and 'abreactive' type of non-epileptic attack disorder (see Part I). The incidence of a history of previous abuse was similar to the two control groups for other types of non-epileptic attack disorder. The swoon was seen as a cut-off phenomenon: the abreactive attack as a kind of acting out the memory of the abuse, part of a post-traumatic stress disorder. Both may respond to counselling for the abuse although it is too early to be certain, and there is a risk of further episodes of the non-epileptic attack disorder during periods of stress. Some patients with epilepsy, however, also had a history of previous sexual abuse: in some the stress of the abuse may have precipitated the epileptic seizures.
Betts
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Department of Psychiatry, Queen Elizabeth Psychiatric Hospital, Birmingham, UK.
Boden
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D000293:Adolescent; D002648:Child; D002650:Child Abuse, Sexual / Q000150:complications* / Q000175:diagnosis; D004827:Epilepsy / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D006801:Humans; D007046:Hysteria / Q000175:diagnosis / Q000628:therapy; D008297:Male; D011369:Professional-Patient Relations; D011379:Prognosis; D011613:Psychotherapy; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000523:psychology