Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.
Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA; Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA; Department of Neurology, University of Washington, Seattle, WA, USA.
Epilepsy Behav. 2020 Sep;110:107160. doi: 10.1016/j.yebeh.2020.107160. Epub 2020 Jun 1.
There is no information on disparities of patients with psychogenic nonepileptic seizures (PNES) and their caregivers. The objective of this exploratory study is to compare patients with PNES and caregivers with low socioeconomic status (SES) with those of high SES for disparities in healthcare use, seizures, medication adverse effects, psychosocial impact, and knowledge about epilepsy.
Patients with PNES and caregivers completed surveys about the aforementioned outcomes during their Epilepsy Monitoring Unit (EMU) admission. Associations were evaluated using SES as a binary independent variable and the patient- and caregiver-related outcomes as dependent variables.
Forty-three patients and 28 caregivers were recruited. The majority of patients were on average 36 years old, single women, unemployed, with some college education. The majority had PNES for 8 years averaging 20 seizures per month and were maintained on ≥2 antiepileptic drugs (AEDs) prior to their EMU admission. Most caregivers were first-degree relatives with a mean age of 43 years, married employed women of higher educational attainment, typically cohabitating with the patients. Low SES patients showed poorer knowledge about epilepsy (p < 0.0001) and higher anxiety levels (p = 0.03). Conversely, high SES patients demonstrated poorer social functioning (p = 0.04). High SES caregivers showed higher caregiving burden (p = 0.01).
There are noteworthy disparities in patients with PNES of different SES and their caregivers. Identification of those disparities is a critical step in the creation of appropriate interventions to address them.
目前尚无关于心因性非癫痫性发作（PNES）患者及其照顾者之间差异的信息。本探索性研究的目的是比较社会经济地位（SES）较低和较高的 PNES 患者及其照顾者在医疗保健利用、发作、药物不良反应、心理社会影响以及对癫痫的认识方面的差异。
在癫痫监测单元（EMU）入院期间，PNES 患者及其照顾者完成了上述结局的调查。使用 SES 作为二元自变量，并将患者和照顾者相关结局作为因变量，评估关联。
共招募了 43 名患者和 28 名照顾者。患者平均年龄为 36 岁，多为单身女性，失业，接受过一些大学教育。大多数患者平均每月发作 20 次，PNES 持续 8 年，在入院前已使用≥2 种抗癫痫药物（AEDs）。大多数照顾者是一级亲属，平均年龄为 43 岁，已婚，受教育程度较高，通常与患者同住。SES 较低的患者对癫痫的认识较差（p<0.0001），焦虑水平较高（p=0.03）。相反，SES 较高的患者社会功能较差（p=0.04）。SES 较高的照顾者的照顾负担较重（p=0.01）。
不同 SES 的 PNES 患者及其照顾者之间存在显著差异。确定这些差异是制定适当干预措施以解决这些差异的关键步骤。
