Long-term course of psychogenic nonepileptic seizures: Who gets seizure-free, has better functional level and higher health-related quality of life?

Dissociative seizures Global outcome Psychogenic nonepileptic seizures Quality of life Social functioning functional/dissociative seizures (FDS)

Journal

Epilepsy & behavior : E&B
ISSN: 1525-5069
Titre abrégé: Epilepsy Behav
Pays: United States
ID NLM: 100892858

Informations de publication

Date de publication:
Nov 2023
Historique:
received: 20 07 2023
revised: 26 09 2023
accepted: 26 09 2023
medline: 4 12 2023
pubmed: 16 10 2023
entrez: 15 10 2023
Statut: ppublish

Résumé

The disease course of psychogenic nonepileptic seizures (PNES) over a prolonged period of time remains unclear. The aims of the study were: 1. to describe the course of illness with a median follow-up time of 4 years and a range of 2-15 years; and 2. to identify distinguishing features between participants regarding seizure cessation, functional level and health-related quality of life. Formerly, inpatients of an epileptic ward diagnosed with PNES between 2000 and 2013 were contacted via mail. They were asked by questionnaire about illness characteristics, i.e., age at onset, PNES status at onset and in the course, treatments, psychosocial situation, and quality of life status. Two-thirds of the N = 63 formerly inpatients were female, their age at onset was 26.7 years. Seizure frequency decreased significantly over time, 31.7% were currently seizure-free, but still only 37% were regularly employed. Only 48% had a satisfying health-related quality of life. The remitted participants had a shorter duration of illness and higher health-related quality of life. Participants with a good level of functioning were more likely to be male, took fewer medications, and had a higher health-related quality of life. Those participants with higher quality of life were more frequently employed and had fewer seizures. As participants continue to be severely limited in their functional level and quality of life over the period under review, enhanced treatment approaches that address experiential avoidance seem to be needed.

Sections du résumé

BACKGROUND BACKGROUND
The disease course of psychogenic nonepileptic seizures (PNES) over a prolonged period of time remains unclear. The aims of the study were: 1. to describe the course of illness with a median follow-up time of 4 years and a range of 2-15 years; and 2. to identify distinguishing features between participants regarding seizure cessation, functional level and health-related quality of life.
METHODS METHODS
Formerly, inpatients of an epileptic ward diagnosed with PNES between 2000 and 2013 were contacted via mail. They were asked by questionnaire about illness characteristics, i.e., age at onset, PNES status at onset and in the course, treatments, psychosocial situation, and quality of life status.
RESULTS RESULTS
Two-thirds of the N = 63 formerly inpatients were female, their age at onset was 26.7 years. Seizure frequency decreased significantly over time, 31.7% were currently seizure-free, but still only 37% were regularly employed. Only 48% had a satisfying health-related quality of life. The remitted participants had a shorter duration of illness and higher health-related quality of life. Participants with a good level of functioning were more likely to be male, took fewer medications, and had a higher health-related quality of life. Those participants with higher quality of life were more frequently employed and had fewer seizures.
CONCLUSIONS CONCLUSIONS
As participants continue to be severely limited in their functional level and quality of life over the period under review, enhanced treatment approaches that address experiential avoidance seem to be needed.

Identifiants

pubmed: 37839244
pii: S1525-5050(23)00382-7
doi: 10.1016/j.yebeh.2023.109463
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

109463

Informations de copyright

Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have seemed to influence the work reported in this paper.

Auteurs

Carmen Uhlmann (C)

Department of Psychiatry and Psychotherapy I (Weissenau), Ulm University, Ulm, Germany; Centres for Psychiatry Suedwuerttemberg, Ravensburg, Germany.

Petra Schmid (P)

Department of Psychiatry and Psychotherapy I (Weissenau), Ulm University, Ulm, Germany; Centres for Psychiatry Suedwuerttemberg, Ravensburg, Germany. Electronic address: petra.schmid@zfp-zentrum.de.

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Classifications MeSH