Psychiatric comorbidity in veterans with psychogenic seizures

Abstract Psychogenic non-epileptic seizures (PNES) are frequently encountered in epilepsy monitoring units (EMU) at Veterans Affairs Medical Centers (VAMCs) and cause significant long-term disability. An understanding of psychiatric factors associated with PNES could aid in earlier diagnosis and tre...

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Bibliographic Details
Published in:Epilepsy & behavior 2012-11, Vol.25 (3), p.345-349
Main Authors: Salinsky, Martin, Evrard, Collette, Storzbach, Daniel, Pugh, Mary Jo
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Classification
Comorbidity
Conversion Disorder - diagnosis
Conversion Disorder - epidemiology
Conversion Disorder - psychology
Depression
Diagnosis, Differential
Disability Evaluation
Drug abuse
Epilepsy
Female
Hospitals, Veterans
Humans
Logistic Models
Longitudinal Studies
Male
Mental disorders
Mental Disorders - diagnosis
Mental Disorders - epidemiology
Middle Aged
Neurology
Post-traumatic stress disorder
Psychogenic seizures
Psychophysiologic Disorders - diagnosis
Psychophysiologic Disorders - epidemiology
Psychophysiologic Disorders - psychology
Regression analysis
Seizures
Seizures - diagnosis
Seizures - epidemiology
Seizures - psychology
Veterans
Young Adult
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Summary:Abstract Psychogenic non-epileptic seizures (PNES) are frequently encountered in epilepsy monitoring units (EMU) at Veterans Affairs Medical Centers (VAMCs) and cause significant long-term disability. An understanding of psychiatric factors associated with PNES could aid in earlier diagnosis and treatment. We studied 50 consecutive veterans diagnosed with PNES and 37 veterans diagnosed with epileptic seizures (ES), evaluated at a VAMC EMU. We reviewed all available mental health evaluations prior to EMU evaluation. Univariate comparisons included axis I diagnoses, axis II diagnoses, and psychiatric hospitalizations. Predictive models of seizure classification were evaluated by logistic regression. A diagnosis of post-traumatic stress disorder (PTSD) preceded the diagnosis of PNES in 58% of patients and the diagnosis of ES in 13.5% (p < 0.001). On logistic regression, PTSD was the only significant psychiatric diagnosis (odds ratio 9.2). Major depression and alcohol abuse were common diagnoses but did not differentiate PNES and ES groups.
ISSN:1525-5050
1525-5069
DOI:10.1016/j.yebeh.2012.07.013