Psychological Non Epileptic Seizures
Northeast Regional Epilepsy Group

New article compares patients with psychogenic non-epileptic seizures (PNES) to patients with intractable partial epilepsy on trauma, somatization and dissociation

This month, several colleagues at the Northeast Regional Epilepsy Group published a new article: “Psychological trauma, somatization, dissociation, and psychiatric comorbidities in patients with psychogenic nonepileptic seizures compared with those in patients with intractable partial epilepsy.”

The initial aim of the project was to better understand psychological trauma in PNES and in persons with epilepsy (PWEs) and to see whether there were any notable differences or similarities to be seen. There has been somewhat limited research into psychological trauma in PWEs, but the existing studies that exist on this topic show that those with epilepsy certainly experience their fair share of trauma. In fact, reports show that PWEs face domestic violence, bullying and discrimination in surprisingly high numbers. Additionally, some researchers have suggested that the actual experience of having epilepsy (i.e. a chronic condition with unexpected and sudden attacks and potential for injury) can in itself be potentially traumatizing.

As for PNES, there are multiple reports of psychological trauma and life adversities in these patients’ histories. In fact, psychological trauma is considered one of the most typical risk factors for PNES.

As we progressed with our work, we also ended up looking at certain scales from the Trauma Symptom Inventory 2 (Dissociation, Somatization, etc.) and at psychiatric histories. Our final product revealed that patients with PNES differed significantly from PWEs on a Somatization scale but not on the Dissociation scale which was a bit of a surprise (although in our discussion, we speculate on some reasons why this might have been so). Those with PNES also exhibited significantly higher rates of sexual and “other” trauma compared with those with intractable epilepsy. No significant differences were found between the two groups on rates of physical abuse. One other important contribution the paper makes is through the meticulous presentation of the diverse range of trauma types and life adversities found in both groups of patients. This is important because too often when clinicians or researchers think of trauma, they limit themselves to two basic categories: sexual or physical abuse. This publication shows that trauma and stressors found in these populations is much more varied than that. As a result, clinicians may want to widen their set of questions when interviewing patients regarding traumatic life experiences.

If interested in reading the complete article, go here: https://www.epilepsybehavior.com/article/S1525-5050(18)30956-9/fulltext

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