Northeast Regional Epilepsy Group, New York, United States; CAPHRI School for Public Health and Primary Care, Department of Health Services Research, Maastricht University, Maastricht, the Netherlands.
Northeast Regional Epilepsy Group, New York, United States.
Epilepsy Behav. 2019 Mar;92:341-344. doi: 10.1016/j.yebeh.2019.01.024. Epub 2019 Feb 13.
Psychogenic nonepileptic seizures (PNES) have the appearance of epileptic seizures, yet show no epileptiform discharges in the brain. The quality of life (QOL) in patients with PNES is reportedly low and trauma eems to be a relevant risk factor. The objective of this study was to examine the difference between measures of (epilepsy-specific) QOL (Quality of Life in Epilepsy Inventory; QOLIE-31p) and psychological dysfunction (trauma symptom inventory; TSI) between patients with diagnosed PNES with self-reported trauma and those without self-reported trauma.
Patients whose PNES diagnoses were through video-electroencephalogram (EEG) monitoring at the Northeast Regional Epilepsy Group between 2008 and 2018 were included. Patients who reported to have a history of psychological trauma and those who did not were assigned to separate groups. Scores from the TSI and QOLIE-31p were compared by using multivariate analysis of covariance.
The total sample was comprised of 217 adult patients, 148 of which self-reported as having experienced psychological trauma in the past and 69 who did not report any psychological trauma. Traumatized patients significantly differed in terms of QOL and TSI from nontraumatized patients. Traumatized patients were demonstrated to have lower scores on the subdomain "energy" of the QOLIE-31p and the total QOLIE-31p score compared to the nontraumatized group. Similarly, the traumatized group had significantly higher scores on nearly all TSI subscales with the exception of suicidality, sexual disturbances, and somatization.
This study demonstrated significant differences between patients with PNES who have been psychologically traumatized and those who have not. In particular, patients with a history of psychological trauma present greater psychopathology and would possibly benefit from rapid identification and referral to trauma-based therapy. In turn, this may result in a reduction of disease burden, increase QOL, and a reduction in healthcare costs resulting from diagnostic delays and implementation of less targeted treatments.
心因性非癫痫性发作（PNES）表现为癫痫发作的外观，但在大脑中没有癫痫样放电。据报道，PNES 患者的生活质量（QOL）较低，而创伤似乎是一个相关的风险因素。本研究的目的是检查有或无自我报告创伤的 PNES 患者之间（癫痫特有的）QOL（癫痫生活质量量表；QOLIE-31p）和心理功能障碍（创伤症状量表；TSI）测量值的差异。
纳入 2008 年至 2018 年间在东北区域癫痫组通过视频-脑电图（EEG）监测诊断为 PNES 的患者。将报告有心理创伤史和无心理创伤史的患者分为两组。使用协方差的多变量分析比较 TSI 和 QOLIE-31p 的评分。
总样本包括 217 名成年患者，其中 148 名报告过去有心理创伤史，69 名无任何心理创伤史。与非创伤组相比，创伤组患者在 QOL 和 TSI 方面存在显著差异。与非创伤组相比，创伤组患者在 QOLIE-31p 的“能量”子域和总 QOLIE-31p 评分方面得分较低。同样，与非创伤组相比，创伤组在 TSI 的几乎所有子量表上的得分都明显较高，除了自杀意念、性障碍和躯体化。
本研究表明，有心理创伤和无心理创伤的 PNES 患者之间存在显著差异。特别是，有心理创伤史的患者表现出更大的精神病理学，可能会受益于快速识别和转介到基于创伤的治疗。反过来，这可能会减少疾病负担，提高 QOL，并减少由于诊断延迟和实施针对性较差的治疗而导致的医疗保健成本。
