Szaflarski Jerzy P, Szaflarski Magdalena, Hughes Cindy, Ficker David M, Cahill William T, Privitera Michael D
Department of Neurology, University of Cincinnati Medical Center, Cincinnati, OH, USA.
Med Sci Monit. 2003 Apr;9(4):CR113-8.
HRQOL is lower in patients with psychogenic non-epileptic seizures (PNES) than in epilepsy patients. Although psychopathology may reduce HRQOL, it is not known whether patients with PNES and epilepsy are similarly affected. We aimed to compare the relationship between psychopathology and HRQOL in PNES and treatment resistant epilepsy.
MATERIAL/METHODS: 106 patients with definite diagnosis of PNES or epilepsy were recruited from Epilepsy Monitoring Unit. Patients completed QOLIE-89, Profile of Mood States (POMS), and Adverse Events Profile (AEP). Total Mood Disturbance (TMD) was derived from POMS. We used chi-square and t tests and hierarchical multiple regression to compare HRQOL and its mental status correlates in patients with PNES and epilepsy.
Psychiatric history was more prevalent and depression/dejection and TMD were higher in PNES than epilepsy (P<=0.003). PNES patients had a lower adjusted mean HRQOL than epilepsy patients (P<0.01). Mood problems and AEP were strong predictors of HRQOL (P<0.001) and explained the lower HRQOL in PNES vis-l-vis epilepsy. Decreases in HRQOL due to mood problems were similar in both groups. The model explained 62% of the variation in HRQOL.
Although more severe psychopathology in PNES explains the lower HRQOL in PNES relative to epilepsy, the negative association between psychopathology and HRQOL remains stable across the groups. PNES patients with severe mood problems show similar, low levels of HRQOL as patients with severe mood problems who have epilepsy. Future studies should examine causal linkages between psychopathology and PNES and other explanations in seizure-related QOL.
与癫痫患者相比，精神性非癫痫性发作（PNES）患者的健康相关生活质量（HRQOL）更低。尽管精神病理学可能会降低HRQOL，但尚不清楚PNES患者和癫痫患者是否受到类似影响。我们旨在比较PNES和药物难治性癫痫患者精神病理学与HRQOL之间的关系。
材料/方法：从癫痫监测单元招募了106例确诊为PNES或癫痫的患者。患者完成了癫痫生活质量量表-89（QOLIE-89）、情绪状态量表（POMS）和不良事件量表（AEP）。总情绪紊乱（TMD）由POMS得出。我们使用卡方检验、t检验和分层多元回归来比较PNES患者和癫痫患者的HRQOL及其精神状态相关性。
PNES患者的精神病史更为普遍，抑郁/沮丧和TMD高于癫痫患者（P≤0.003）。PNES患者调整后的平均HRQOL低于癫痫患者（P<0.01）。情绪问题和AEP是HRQOL的强预测因素（P<0.001），并解释了PNES患者相对于癫痫患者HRQOL较低的原因。两组因情绪问题导致的HRQOL下降相似。该模型解释了HRQOL变异的62%。
尽管PNES患者中更严重的精神病理学解释了其相对于癫痫患者HRQOL较低的原因，但精神病理学与HRQOL之间的负相关在各组中保持稳定。有严重情绪问题的PNES患者与有严重情绪问题的癫痫患者的HRQOL水平相似且较低。未来的研究应检查精神病理学与PNES之间的因果联系以及癫痫相关生活质量的其他解释。
