Differentiating epilepsy from psychogenic nonepileptic seizures using neuropsychological test data

Tyson, Brad; Baker, Shannon D.; Greenacre, Matthew; Kent, Katrina J.; Lichtenstein, Jonathan D.; Sabelli, Alana G.; Erdődi, László A.

doi:10.1016/j.yebeh.2018.08.010

Cited by 54 publications

(26 citation statements)

References 72 publications

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“…13 14 In three studies of psychogenic non-epileptic seizures (PNES, also called dissociative seizures), 13 (10%) of 132 failed the TOMM. [15][16][17] In two other studies of PNES, 25 (44%) of 57 met criterion A (therefore failed) on the standard WMT. 18 19 In two studies of individuals with chronic fatigue syndrome, 374 (25%) of 1526 failed the Amsterdam Short Term Memory Test (scoring <86/100).…”

Section: Functional Disordersmentioning

confidence: 97%

“…21 (online supplementary table 4) Failure rates higher than 25% were reported by Tyson et al in 33 individuals with PNES on RDS (cut-off ≤7), vocabulary-digit span (≥3), forced choice recall on the California Verbal Learning Test (CVLT) (≤15) and the Boston Naming Test 17. epilepsyEleven studies reported PVT performance in people with epilepsy.…”

mentioning

confidence: 96%

“…epilepsyEleven studies reported PVT performance in people with epilepsy. In five studies including 246 people with epilepsy, 31 (13%) failed the TOMM [15][16][17].…”

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confidence: 99%

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Performance validity test failure in clinical populations—a systematic review

McWhirter

Ritchie

Stone

et al. 2020

J Neurol Neurosurg Psychiatry

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Performance validity tests (PVTs) are widely used in attempts to quantify effort and/or detect negative response bias during neuropsychological testing. However, it can be challenging to interpret the meaning of poor PVT performance in a clinical context. Compensation-seeking populations predominate in the PVT literature. We aimed to establish base rates of PVT failure in clinical populations without known external motivation to underperform. We searched MEDLINE, EMBASE and PsycINFO for studies reporting PVT failure rates in adults with defined clinical diagnoses, excluding studies of active or veteran military personnel, forensic populations or studies of participants known to be litigating or seeking disability benefits. Results were summarised by diagnostic group and implications discussed. Our review identified 69 studies, and 45 different PVTs or indices, in clinical populations with intellectual disability, degenerative brain disease, brain injury, psychiatric disorders, functional disorders and epilepsy. Various pass/fail cut-off scores were described. PVT failure was common in all clinical groups described, with failure rates for some groups and tests exceeding 25%. PVT failure is common across a range of clinical conditions, even in the absence of obvious incentive to underperform. Failure rates are no higher in functional disorders than in other clinical conditions. As PVT failure indicates invalidity of other attempted neuropsychological tests, the finding of frequent and unexpected failure in a range of clinical conditions raises important questions about the degree of objectivity afforded to neuropsychological tests in clinical practice and research.

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Section: Functional Disordersmentioning

confidence: 97%

mentioning

confidence: 96%

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Performance validity test failure in clinical populations—a systematic review

McWhirter

Ritchie

Stone

et al. 2020

J Neurol Neurosurg Psychiatry

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“…Another, even more extreme, instance of psychological forces causing bad outcomes is what some researchers term Bpsychogenic death^ (Leach, 2018), a condition where trauma survivors become so engulfed in negative thinking following the traumatic event that they shut down and die for no medically verifiable reason. In contrast, Tyson et al (2018) recently found that patients with PNES have higher cognitive functioning than those with epilepsy, so concluding that PNES always translates into worse functioning is unsupported.…”

Section: Psychological Contributions To Symptom Expression Following mentioning

confidence: 97%

What Attorneys and Factfinders Need to Know About Mild Traumatic Brain Injuries

Kaufman

Bush

Aguilar

2019

Psychol. Inj. and Law

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“…Differentiating psychogenic seizures from epileptic seizures is a major diagnostic challenge. Researchers have proposed an integrative model of management including video-EEG and psychometric psychological batteries as a routine diagnostic approach in special epilepsy clinics to counter the absence of a clear standardized diagnostic regimen to identify PNES among patients presenting with epileptic seizures [9].…”

Section: Introductionmentioning

confidence: 99%

Psychiatric comorbidities in patients with psychogenic nonepileptic seizures

Rady

Elfatatry

Molokhia

et al. 2021

Epilepsy & Behavior

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Background: Psychogenic nonepileptic seizures (PNES) are major challenges for diagnosis and management. The heterogeneity of psychogenic seizures is attributed to diverse psychopathological comorbidities, and the causal relationship between PNES and underlying psychopathologies is still enigmatic. Objective: Our objective was to study psychiatric comorbidities and personality constructs in patients with PNES and compare them to a control group of patients with epilepsy. Method: We randomly recruited 33 patients with PNES and 33 patients with epilepsy. All patients completed the Mini-International Neuropsychiatric Interview (MINI) to screen for psychiatric comorbidities, the Structured Clinical Interview for psychiatric disorders in Axis II (SCID II) to screen for personality disorders, and Goldberg's International Personality Item Pool (IPIP) Big Five personality questionnaire to study the psychological constructs of extroversion-introversion, agreeableness, conscientiousness, emotional stability-neuroticism, and intellect. Result: Mood and anxiety disorders were highly prevalent in patients with PNES (72.7% and 54.5%, respectively); however, the prevalence of only cluster B personality disorder was higher in patients with PNES (69.7%) compared to 33.3% among patients with epilepsy (p < 0.05). Screening for personality disorders using SCID II showed that the prevalence of borderline and depressive personality disorders was significantly higher in patients with PNES (p < 0.001). Patients with psychogenic seizures were more likely to be receiving polydrug therapy (75.8%) compared to patients with epileptic seizures (45.5%); this difference was statistically significant (p < 0.05). Conclusion: Psychiatric comorbidities are highly prevalent among patients with PNES.

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Differentiating epilepsy from psychogenic nonepileptic seizures using neuropsychological test data

Cited by 54 publications

References 72 publications

Performance validity test failure in clinical populations—a systematic review

Performance validity test failure in clinical populations—a systematic review

What Attorneys and Factfinders Need to Know About Mild Traumatic Brain Injuries

Psychiatric comorbidities in patients with psychogenic nonepileptic seizures

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