Psychological Problems and Clinical Outcomes of Children with Psychogenic Non-Epileptic Seizures

Abstract

PurposeOur purpose was to investigate psychological problems and clinical outcomes in children with psychogenic non-epileptic seizures (PNES).Materials and MethodsWe retrospectively reviewed the data of 25 patients who were diagnosed with PNES between 2006 and 2012.ResultsTwenty-five children with PNES, aged 8 to 19 years (mean 13.82), were referred to psychiatrists for psychiatric assessment. On their initial visit, 72% of patients had comorbid psychological problems, including depression, anxiety, conduct disorder, adjustment disorder, Attention Deficit Hyperactivity Disorder, schizophrenia, and bipolar disorder. Among these, depression was the most frequent (36%). Predisposing and triggering factors included familial distress (40%), social distress (24%), and specific events (20%). The following treatment was advised based on the results of the initial psychological assessment: 3 patients regularly visited psychiatric clinic to assess their clinical status without treatment, nine underwent psychotherapy, and 13 received a combination of psychotherapy and psychopharmacological therapy. At the mean follow-up of 31.5 months after diagnosis, 20 patients (80%) were event-free at follow-up, three (12%) showed reduced frequency, and two (8%) experienced persistent symptoms.ConclusionThe outcomes of PNES in children are much better than those in adults, despite a high rate of psychological comorbidities.

Morbidity and mortality of nonepileptic seizures (NES): A controlled national study

“…We did not control for parental social factors. It is likely that this would be of relevance since PNES is probably influenced by social rank [39]. However, the data here were insufficiently complete to enable the familiar analysis that would ideally be required.…”

High Yield of Screening for ADHD in the Epilepsy Monitoring Unit

“…In the pediatric population, attention deficits are associated with PNES. Studies have reported that 7% to 28% of children with PNES are jointly diagnosed with ADHD (Rawat et al, 2015; Yi, Kim, Lee, Cheon, & Kang, 2014). However, the comorbidity of ADHD and PNES in adults has not been characterized.…”

Patient and family perspectives of paediatric psychogenic non-epileptic seizures: A systematic review

“…In comparison to adolescents with epilepsy and healthy controls, a history of traumatising/stressful events, sexual and physical abuse was found to be significantly more common in adolescents with PNES [19]. Yi et al [20] reported that histories of interpersonal or familial distress were seen as precipitants of PNES in their sample. Such traumatic histories were also classified as potential precipitants to PNES onset in the study conducted by Irwin, Edwards and Robinson (2000), with experiences of domestic tension, bullying, dysfunctional maternal relationships, violence, and physical and sexual abuse being reported.…”