Article

Non-Epileptic Seizures (NES) are predicted by depressive and dissociative symptoms

Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, Via Ugo De Carolis, 48 00136 Roma, Italy.
Epilepsy research (Impact Factor: 2.19). 02/2009; 84(2-3):91-6. DOI: 10.1016/j.eplepsyres.2008.12.008
Source: PubMed

ABSTRACT (1) To measure depressive and dissociative symptoms in a population of patients with Non-Epileptic Seizures (NES, or pseudo-seizures); (2) To compare NES with Epileptic subjects and Normal controls; (3) To try to define a personality profile specific, or typical, of NES patients.
Patients: 30 consecutive patients (21 females and 9 males, mean age 32.9+/-11.7 years) with NES diagnosed on clinical basis and confirmed by video-EEG recording; 30 patients with epilepsy matched for age and sex who had presented at least two seizures in the 12 months prior to the study despite pharmacological treatment; 30 Control subjects, healthy volunteers, matched for age and sex. Psychometric evaluation: Hamilton Rating Scale for Depression (HDRS), Dissociative Experience Scale (DES), Minnesota Multiphasic Personality Inventory-2 (MMPI-2). Groups were compared by means of one-way Analysis of Variance (ANOVA) for independent samples, followed by posthoc Tukey HSD Test, with Bonferroni correction for multiple comparisons.
Depressive and dissociative symptoms showed a significantly higher prevalence in the NES group as compared to Epileptics (p<0.001) and Controls (p<0.001), whereas patients with epilepsy did not differ from Controls. The analysis of the MMPI-2 in NES group showed a general increase in most MMPI-2 T-scores as compared to Epileptics and Controls, rather than a constant elevation (T-score>70) of one or more scales. No specific personality profile could be identified for the NES group.
Our results are consistent with the hypothesis that depression and dissociative mechanisms are important precursors to the development and expression of NES.

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    • "These findings show that patients with epilepsy are more prone to experiencing pathological dissociation while having certain factors. As in our finding, previous studies also reported that the DES-S in people with epilepsy was not significantly different from that in nonclinical individuals [13] [14] [25] "
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    • "Such difficulties are often thought to stem from maladaptive attachments with early caregivers, which undermine the development of appropriate ways of understanding and relating to emotional states in oneself and others [11]. Despite the apparent popularity of such concepts, several studies with groups with PNESs have failed to replicate the conversion V profile on the MMPI [12] [13], and the few published studies on alexithymia in PNESs have not demonstrated higher levels of alexithymia in these patients compared with those with epilepsy [10] [14]. One possibility is that these mixed findings reflect the heterogeneity of patients with PNESs in terms of etiology and comorbid psychopathology. "
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