Psychological long‐term outcome in patients with psychogenic nonepileptic seizures

Walther, Katrin; Volbers, Bastian; Erdmann, Laura; Onugoren, Müjgan Dogan; Gollwitzer, Stephanie; Kasper, Burkhard S.; Kurzbuch, Katrin; Lang, Johannes; Schwab, Stefan; Schwarz, Michael; Hamer, Hajo M.

doi:10.1111/epi.14682

Cited by 27 publications

(25 citation statements)

References 41 publications

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“…As previously reported, [27] the majority of our patients continued to experience PNES several years after diagnosis. PNES resolved in only one third of the population.…”

Section: Pnes Outcome and Predictorssupporting

confidence: 82%

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Psychosocial long-term outcome in patients with psychogenic non-epileptic seizures

Walther

Volbers

Erdmann

et al. 2020

Seizure

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“…As previously reported, [27] the majority of our patients continued to experience PNES several years after diagnosis. PNES resolved in only one third of the population.…”

Section: Pnes Outcome and Predictorssupporting

confidence: 82%

“…Selection of participants and study procedure have been described in detail in Walther et al [27]. Briefly, patients admitted to the Erlangen Epilepsy Center between 2000 and 2016 and diagnosed with PNES were identified as potential candidates for inclusion, if follow-up of at least 12 months was available (n = 195).…”

Section: Patientsmentioning

confidence: 99%

Psychosocial long-term outcome in patients with psychogenic non-epileptic seizures

Walther

Volbers

Erdmann

et al. 2020

Seizure

Self Cite

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“…Psychogenic non-epileptic seizures (PNES) are an important differential diagnosis and a common neuropsychiatric comorbidity of epilepsy (LaFrance et al, 2013). Long-term prognosis of PNES has been shown to be poor in patients with PNES after the communication of the diagnosis in an epilepsy monitoring unit setting (Walther et al, 2019). Psychological interventions have been recognized as the treatment of choice for PNES (Goldstein et al, 2020) and adherence to psychotherapy yields significant improvement in PNES frequency and quality of life (Tolchin et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Screening for Psychiatric Comorbidities and Psychotherapeutic Assessment in Inpatient Epilepsy Care: Preliminary Results of an Implementation Study

Michaelis

Schlömer

Lindemann

et al. 2021

Front. Integr. Neurosci.

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Background: Anxiety and depression remain underdiagnosed in routine clinical practice in up to two thirds of epilepsy patients despite significant impact on medical and psychosocial outcome. Barriers to adequate mental health care for epilepsy and/or psychogenic non-epileptic seizures (PNES) include a lack of integrated mental health specialists and standardized procedures. This naturalistic study outlines the procedures and outcome of a recently established psychotherapeutic service.Methods: Routine screening included the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E, cut-off value > 13) and Generalized Anxiety Disorder scale (GAD-7, cut-off value > 5). Positively (above cut-off in at least one questionnaire) screened patients were seen for a standardized interview for mental health disorders and the development of a personalized treatment plan. PNES patients were seen irrespective of their screening score. Resources were provided to support self-help and access to psychotherapy. Patients were contacted 1 month after discharge to evaluate adherence to therapeutic recommendations.Results: 120 patients were screened. Overall, 56 of 77 positively screened patients (77%) were found to have a psychiatric diagnosis through standardized interview. More epilepsy patients with an anxiety disorder had previously been undiagnosed compared to those with a depressive episode (63% vs. 30%); 24 epilepsy patients (62%) with a psychiatric comorbidity and 10 PNES patients (59%) were not receiving any mental health care. At follow-up, 16/17 (94%) epilepsy patients and 7/7 PNES patients without prior psychiatric treatment were adhering to therapeutic recommendations.Conclusion: Integrating mental health specialists and establishing standardized screening and follow-up procedures improve adherence to mental health care recommendations in epilepsy and PNES patients.

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“…12 Many studies focused on long-term outcomes lose a large subset of their population at follow-up, complicating interpretation of results. 8,12,17 A prior paper describes the multidisciplinary pediatric PNES clinic at Nationwide Children's Hospital. 21 Collaboration by neurology and psychology clinicians, social workers, and nurses supported patients in accessing needed health care and facilitated follow-up.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of children and adolescents 1 year after being seen in a multidisciplinary psychogenic nonepileptic seizures clinic

et al. 2021

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Objective: Psychogenic nonepileptic seizures (PNES) are paroxysmal events that may involve altered subjective experience and change in motor activity with a psychological cause. The aim of this work is to describe a population of pediatric patients with PNES and identify factors predictive of 12-month outcomes. Methods:We conducted a prospective observational study of children and adolescents referred to the multidisciplinary Nationwide Children's Hospital PNES clinic between November 2017 and July 2019. Information was collected from patients during clinic visits and semistructured follow-up phone calls. Descriptive statistics and Fisher exact test were used for analysis.Results: Of the 139 consecutive patients referred to the PNES clinic, 104 were seen in clinic and 63 answered 12-month follow-up calls. Patients with comorbid epilepsy had increased rates of participation at 12-month follow-up (p = .04). Complete remission was achieved by 32% (20/63) of patients at 12 months. Combined PNES remission and improvement was 89% (56/63) at 12 months. Patients and families who were linked with counseling at 1 month were more likely to achieve remission at 12 months (p = .005). Less than half (44%, 28/63) of patients reached at 12 months had their events documented on video-electroencephalogram (EEG) at diagnosis; however, those who did were not more likely to be accepting of the diagnosis at 12 months (p = 1.0), be linked with counseling at 12 months (p = .59), or be event-free at 12 months (p = .79).Significance: Remission occurred in one third of patients by 12 months; however, improvement in events was seen in 89%. Connection to counseling by 1 month was associated with increased remission rates at 12 months. Capturing events on video-EEG was not associated with increased acceptance or event freedom at 12 months. Diagnosis should be followed by strong encouragement to connect with counseling quickly to achieve a goal of increasing 12-month PNES remission rates.

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Psychological long‐term outcome in patients with psychogenic nonepileptic seizures

Cited by 27 publications

References 41 publications

Psychosocial long-term outcome in patients with psychogenic non-epileptic seizures

Psychosocial long-term outcome in patients with psychogenic non-epileptic seizures

Screening for Psychiatric Comorbidities and Psychotherapeutic Assessment in Inpatient Epilepsy Care: Preliminary Results of an Implementation Study

Outcomes of children and adolescents 1 year after being seen in a multidisciplinary psychogenic nonepileptic seizures clinic

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