An estimate of the prevalence of psychogenic non-epileptic seizures

Benbadis, Selim R.; Hauser, W. Allen

doi:10.1053/seiz.2000.0409

Cited by 454 publications

(251 citation statements)

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“…Because clinically PNESs are very similar to ESs, it is reasonable to assume that the effects of PNESs on HRQOL are similar to the effects ESs have on patients with pharmacoresistant epilepsy. The prevalence of PNESs is ∼2-33/100,000 of the general population and between 10 and 58% of the patients with intractable epilepsy seen in specialized epilepsy centers (15,19). The incidence of definite PNESs is 1.4-3.03/100,000 per year (20,21); thus the number of patients with PNESs could be as high as 300,000 to 400,000 (22).…”

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Quality of Life in Psychogenic Nonepileptic Seizures

Szaflarski¹,

Hughes²,

et al. 2003

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Summary:Purpose: Psychogenic nonepileptic seizures (PNESs) are events that alter or seem to alter the neurologic function and, in their appearance, resemble epileptic seizures (ESs). In patients with ESs the psychological and medical aspects of epilepsy greatly influence the health-related quality of life (HRQOL). The relation between these factors and PNESs is not well established. In this study, we compared HRQOL in patients with PNESs with that of patients with ESs.Methods: We evaluated 105 patients admitted to the Epilepsy Monitoring Unit of University Hospital between January 20, 2001, and January 20, 2002. Only patients with the definite diagnosis of ESs or PNESs were analyzed (n ‫ס‬ 85). Patients completed an epilepsy-specific quality-of-life instrument (QOLIE-89), the Profile of Mood States (POMS), and Adverse Events Profile (AEP). We used t tests and regression analyses to contrast HRQOL in PNESs and ESs and to elucidate the main factors associated with HRQOL in patients with PNESs.Results: In our sample, 45 patients had PNESs, and 40 hadESs. The overall HRQOL and scores on 13 of 19 QOLIE-89 subscales were significantly lower (i.e., worse) in PNES than in ES patients. AEP and scores on five of six POMS subscales also were worse in PNES patients than in ES patients. PNES versus ES diagnosis, POMS depression/dejection, and AEP were significant predictors of HRQOL, jointly explaining 65% variation in HRQOL. The lower HRQOL in PNESs versus ESs was in part explained by depression and AEP.Conclusions: Patients with PNESs have a lower HRQOL and worse mood problems than do patients with ESs. This disadvantage is primarily due to depression and medication side effects, although these factors influence QOL in much the same way in PNES and ES patients. These baseline HRQOL data on patients with PNESs can be used to evaluate the effects of treatment in this patient population.

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“…Because PNESs are common (19,20), effective therapies should be identified. In the meantime, more knowledge is needed about the demographic, social, and psychological factors leading to and associated with this illness.…”

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confidence: 99%

Quality of Life in Psychogenic Nonepileptic Seizures

Szaflarski¹,

Hughes²,

et al. 2003

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“…In contrast, between 10 and 20% of patients referred to epilepsy centers have PNESs, thus constituting a major differential diagnosis for epileptic seizures (2,3). The disorder is frequently of long duration, and there is no general agreement on the best treatment (4-6).…”

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Psychiatric Comorbidity and Hostility in Patients with Psychogenic Nonepileptic Seizures Compared with Somatoform Disorders and Healthy Controls

Mokleby¹,

Blomhoff²,

Malt³

et al. 2002

Epilepsia

115

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Summary:Purpose: To investigate the prevalence of psychiatric comorbidity and level of anxiety, depression, and aggression in patients with psychogenic nonepileptic seizures compared with those in patients with somatoform disorders and healthy controls.Methods: Twenty-three patients with psychogenic nonepileptic seizures (PNESs) and 23 age-and sex-matched patients with somatoform disorders (SDs) underwent a clinical and a semistructured psychiatric interview (MINI) and filled in the Hospital Anxiety and Depression scale (HAD) and the Aggression Questionnaire (AQ). Twenty-three sex-and age-matched controls without psychopathology also underwent a clinical interview and completed the HAD and AQ.Results: PNES reported more minor head injuries in the past than did the two comparison groups, and more unspecific EEG dysrhythmias were observed on EEG. Twenty-one PNES patients and 18 with SDs had comorbid psychiatric diagnoses. However, the mean number of comorbid psychiatric diagnoses was higher in the PNES group (1.9 ± 0.3 compared with 1.5 ± 0.5 in the SD group; p ‫ס‬ 0.003). Ten PNES patients additionally had a somatoform pain disorder, and seven had an undifferentiated somatoform disorder. Both patient groups reported significantly higher levels of anxiety, depression, and anger than did the healthy controls, but the PNES patients had significantly higher level of hostility than both comparison groups.Conclusions: Increased psychiatric comorbidity is known to be associated with poorer response to regular interventions, and hostility is associated with more hostile coping patterns, often interfering with treatment compliance. Thus the increased prevalence of soft neurologic signs and comorbid psychiatric disorders and increased hostility as well in the PNES group, emphasizes that assessment and treatment of patients with PNES referred to a tertiary center requires an integrated approach involving both neurologic and psychiatric resources.

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“…Recognized as a public health problem, 1 PNES may be defined as episodes of changes in movements, sensations or experiences similar to epilepsy caused by psychological process not associated with cerebral electrical discharge. 2 Its prevalence in the general population is difficult to calculate given that it is underreported and an accurate diagnosis is difficult to perform.…”

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confidence: 99%