Szaflarski Jerzy P, Hughes Cynthia, Szaflarski Magdalena, Ficker David M, Cahill William T, Li Maureen, Privitera Michael D
Department of Neurology and Institute for Health Policy and Health Services Research, University of Cincinnati, Cincinnati, Ohio, U.S.A.
Epilepsia. 2003 Feb;44(2):236-42. doi: 10.1046/j.1528-1157.2003.35302.x.
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.
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 = 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.
In our sample, 45 patients had PNESs, and 40 had ESs. 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.
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.
心因性非癫痫性发作（PNES）是改变或似乎改变神经功能的事件，其表现类似于癫痫发作（ES）。在癫痫患者中，癫痫的心理和医学方面极大地影响与健康相关的生活质量（HRQOL）。这些因素与PNES之间的关系尚未明确确立。在本研究中，我们比较了PNES患者与ES患者的HRQOL。
我们评估了2001年1月20日至2002年1月20日期间入住大学医院癫痫监测病房的105例患者。仅对确诊为ES或PNES的患者进行分析（n = 85）。患者完成了一份癫痫特异性生活质量量表（QOLIE - 89）、情绪状态量表（POMS）和不良事件量表（AEP）。我们使用t检验和回归分析来对比PNES和ES患者的HRQOL，并阐明与PNES患者HRQOL相关的主要因素。
在我们的样本中，45例患者患有PNES，40例患有ES。PNES患者的总体HRQOL以及QOLIE - 89的19个分量表中的13个分量表得分显著低于（即更差）ES患者。PNES患者的AEP以及POMS六个分量表中的五个分量表得分也比ES患者差。PNES与ES诊断、POMS抑郁/沮丧以及AEP是HRQOL的显著预测因素，共同解释了HRQOL中65%的变异。PNES患者的HRQOL低于ES患者部分是由抑郁和AEP所解释。
与ES患者相比，PNES患者的HRQOL更低，情绪问题更严重。这种劣势主要归因于抑郁和药物副作用，尽管这些因素对PNES和ES患者生活质量的影响方式大致相同。这些关于PNES患者的基线HRQOL数据可用于评估该患者群体的治疗效果。
