Universidad de Buenos Aires (UBA), Facultad de Medicina, IBCN (Instituto de Biología Celular y Neurociencias) - Consejo Nacional de Investigaciones Científicas y Técnicas de Argentina (CONICET), Argentina; Universidad de Buenos Aires (UBA), Facultad de Medicina, Centro de Epilepsia del Hospital Ramos Mejía, Buenos Aires, Argentina.
Universidad de Buenos Aires (UBA), Facultad de Medicina, Centro de Epilepsia del Hospital Ramos Mejía, Buenos Aires, Argentina; Universidad de Buenos Aires (UBA), Facultad de Psicología-CONICET, Argentina.
Seizure. 2021 Nov;92:174-181. doi: 10.1016/j.seizure.2021.09.004. Epub 2021 Sep 10.
Psychiatric disorders are frequently found in both patients with PNES and DRE, making the differential diagnosis even more complex. The aim of this study was to analyze and compare psychiatric aspects and the quality of life in patients with psychogenic non-epileptic seizures (PNES) and drug resistant epilepsy (DRE).
Patients admitted to video-electroencephalograpy (VEEG) unit with confirmed PNES and DRE were included. Demographical characteristics, psychiatric diagnosis according to SCID I and II of DSM IV, pharmacological treatment, general functioning measured with GAF (Global assessment of functionality), quality of life (QoL) using QlesQSF (Quality of Life Enjoyment and Satisfaction Questionnaire Short Form) and depression severity using BDI II (Beck depression inventory), were compared between the groups. Non-parametric tests, chi square test, and logistic regression were used for statistical analysis.
148 patients consecutively admitted to VEEG were included (DRE n = 97; PNES n = 51). Somatization disorder (RR: 13.02, 95% CI: 1.23-137.39, p = 0.03) and a history of trauma (RR: 8.66, 95% CI: 3.21-23.31, p = 0.001) were associated with PNES. The QlesQ score and the GAF score were lower with a higher prevalence of suicide attempts in the PNES group (p < 0.01). A negative correlation was observed between the severity of depression and the quality of life (DRE r = - 0.28, p = 0.013; PNES r = - 0.59, p = 0.001).
Higher psychiatric comorbidity with poorer QoL were found in PNES patients compared to DRE. However, depression comorbidity negatively affected the QoL in both groups. Future studies based on illness perception will be orientated to complete this analysis.
精神障碍在非癫痫性发作（PNES）和耐药性癫痫（DRE）患者中均较为常见，这使得鉴别诊断更加复杂。本研究旨在分析和比较心因性非癫痫性发作（PNES）和耐药性癫痫（DRE）患者的精神科方面和生活质量。
纳入经视频脑电图（VEEG）确诊为 PNES 和 DRE 的患者。比较两组患者的人口统计学特征、DSM-IV 中 SCID I 和 II 的精神科诊断、药物治疗、用 GAF（总体功能评估）评估的一般功能、使用 QlesQSF（生活质量享受和满意度问卷短表）评估的生活质量以及使用 BDI II（贝克抑郁量表）评估的抑郁严重程度。采用非参数检验、卡方检验和逻辑回归进行统计学分析。
共纳入 148 例连续接受 VEEG 检查的患者（DRE 组 n=97；PNES 组 n=51）。躯体化障碍（RR：13.02，95%CI：1.23-137.39，p=0.03）和创伤史（RR：8.66，95%CI：3.21-23.31，p=0.001）与 PNES 相关。PNES 组的 QlesQ 评分和 GAF 评分较低，自杀未遂的发生率较高（p<0.01）。PNES 组和 DRE 组的抑郁严重程度与生活质量呈负相关（r=-0.28，p=0.013；r=-0.59，p=0.001）。
与 DRE 相比，PNES 患者的精神共病率更高，生活质量更差。然而，抑郁共病对两组的生活质量都有负面影响。基于疾病认知的未来研究将有助于完成这一分析。
