The persistent genital arousal disorder (PGAD) may coexist with restless legs syndrome and overactive bladder syndrome and share some similarities with these conditions. Thus, the new term: restless genital syndrome (RGS) is proposed. The purpose of this paper is to present a case of PGAD, including the description of the etiology, the diagnostics and the treatment of the disorder. The described patient meets the criteria for PGAD. Organic lesions within nervous and urogenital system were excluded and the psychogenic background of the syndrome was assumed in this case. The patient was diagnosed with personality disorder with a predominance of dependent personality traits and emotional lability. After the failure of pharmacological treatment, systemic psychotherapy with cognitive-behavioral elements was initiated with moderate effect.
Zaburzenia psychiczne występują u chorych na padaczkę znamiennie częściej niż w populacji ogólnej, a także niż w przebiegu innych przewlekłych schorzeń. Współistnieniu tych zaburzeń sprzyja specyfika padaczki jako schorzenia ośrodkowego układu nerwowego ze złożonymi następstwami somatycznymi, psychicznymi i społecznymi. Ponadto sugerowane są wspólne patomechanizmy padaczki i zaburzeń psychicznych, związane z zaburzeniami czynności bioelektrycznej oraz neuroprzekaźnictwa w poszczególnych obszarach mózgu. Autorzy przedstawiają przegląd głównych typów zaburzeń psychicznych obserwowanych u chorych na padaczkę: zaburzenia psychotyczne, afektywne, lękowe, zaburzenia osobowości i zachowania. Omawiają ich epidemiologię i obraz kliniczny, ze szczególnym uwzględnieniem ich związku czasowego z napadami padaczkowymi oraz czynników ryzyka. Podkreślają problemy związane z diagnostyką różnicową oraz opracowaniem optymalnej strategii terapeutycznej. Zaburzenia psychiczne wywierają istotny wpływ na jakość życia i funkcjonowania chorych na padaczkę. Pogłębienie wiedzy na temat wzajemnych relacji między tymi schorzeniami oraz interdyscyplinarna współpraca neurologa i psychiatry sprzyjają wczesnemu, właściwemu rozpoznaniu zaburzeń psychicznych w tej grupie chorych oraz skutecznemu ich leczeniu.
Most MS patients experience moderate to severe stress. ERP abnormalities were found in MS patients who did not have overt cognitive impairment and showed correlations with stress levels and negative affectivity. Event-related potentials may be useful in assessing the influence of stress and emotions on the course of MS.
Objectives: Stress is supposed to be linked with a background of multiple sclerosis (MS) and the disease course. Design: The study aimed to assess the level of stress and coping strategies in MS patients within a year of follow-up and to investigate the relationships between these aspects and factors related—or not—to MS. Methods: In 65 patients with MS, the Perceived Stress Scale (PSS-10), Type D Scale (DS14) and Coping Orientations to Problems Experienced (COPE) were performed at baseline and after a year. Baseline PSS-10, DS-14 and COPE scores were analyzed with regard to demographics, MS duration, treatment, indices of disability and self-reported stressful events (SEs). Final PSS-10 and COPE results were analyzed with reference to MS activity and SE within a year of follow-up. Results: Initially, 67% of patients reported a moderate or high level of stress and 31% met Type-D personality criteria. Diverse coping strategies were preferred, most of which were problem-focused. The negative affectivity DS-14 subscore (NEG) was correlated with disability level. Non-health-related SEs were associated with higher PSS-10 and NEG scores. After a year, the mean PSS-10 score decreased, while COPE results did not change significantly. Non-health-related SEs were associated with a higher PSS-10 score and less frequent use of acceptance and humor strategies. Those with an active vs. stable MS course during the follow-up did not differ in terms of PSS-10 and COPE results. Conclusions: MS patients experienced an increased level of stress. No significant relationships were found between stress or coping and MS course within a year. Non-health-related factors affected measures of stress more than MS-related factors.
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