Psychological long-term outcome in patients with psychogenic nonepileptic seizures.

Walther, Katrin; Volbers, Bastian; Erdmann, Laura; Dogan Onugoren, Müjgan; Gollwitzer, Stephanie; Kasper, Burkhard S; Kurzbuch, Katrin; Lang, Johannes; Schwab, Stefan; Schwarz, Michael; Hamer, Hajo M (2019). Psychological long-term outcome in patients with psychogenic nonepileptic seizures. Epilepsia, 60(4), pp. 669-678. Wiley 10.1111/epi.14682

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OBJECTIVE To examine the long-term outcome of psychological status, personality, and health-related quality of life (HRQoL) in patients with psychogenic nonepileptic seizures (PNES) and to define predictors of favorable outcome of cessation of PNES. METHOD Patients diagnosed with PNES during video-electroencephalography (EEG) monitoring at the Erlangen Epilepsy Center were contacted 1-16 years after communicating the diagnosis. Follow-up information from each participant was obtained by interview (PNES outcome) and by self-reported questionnaires of psychological symptoms (Beck Depression Inventory-II, Symptom Checklist-90-Standard, Dissociative Symptoms questionnaire), personality traits (Freiburg Personality Inventory-Revised), and HRQoL (36-Item Short Form Health Survey). RESULTS Fifty-two patients participated in the study (mean age ± standard deviation [SD] 40.5 ± 14.0 years; 75% female, follow-up: 5.3 ± 4.2 years). Nineteen patients (37%) were free of PNES for the past 12 months. Patients with persisting PNES were older at disease onset (32.9 vs 22.3 years, P < 0.01) and diagnosis (40.5 vs 27.2 years, P < 0.001), and showed worse psychological functioning, lower extraversion and life satisfaction, and higher inhibitedness and worse HRQoL than PNES-free patients. Patients with cessation of PNES were within the normal range in all dimensions. Cessation of PNES was best predicted by younger age at PNES onset and higher extraversion. SIGNIFICANCE Outcome of PNES is poor, psychopathology is high, and HRQoL is low in patients with persistent PNES but may normalize with PNES cessation. High introversion and older age at PNES onset are risk factors for persistent PNES.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Volbers, Bastian

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0013-9580

Publisher:

Wiley

Language:

English

Submitter:

Chantal Kottler

Date Deposited:

16 Jan 2020 09:37

Last Modified:

16 Jan 2020 09:37

Publisher DOI:

10.1111/epi.14682

PubMed ID:

30838655

Uncontrolled Keywords:

health-related quality of life long-term outcome personality psychogenic nonepileptic seizures psychopathology

BORIS DOI:

10.7892/boris.137745

URI:

https://boris.unibe.ch/id/eprint/137745

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