Dissociation and other clinical phenomena in youth with psychogenic non-epileptic seizures (PNES) compared to youth with epilepsy

Abstract

PurposeTo compare youth with psychogenic non-epileptic seizures (PNES) to youth with epilepsy on demographic and clinical features and the Trauma Symptom Checklist for Children (TSCC). MethodA retrospective study of 31 patients; 15 patients with PNES (11 females) and 16 patients with epilepsy (8 females) collected consecutively between 2014–2018.Demographic and clinical information (age of seizure onset, life adversities, individual/family psychiatric history, etc.) were gathered. Scales from the TSCC (Dissociation, Depression, Anxiety) were analyzed. ResultsEleven of the youth with PNES (YPNES) (73%) were female, mean age was 14.3 ± 1.6 years and years of education were 9 ± 1.9. Eight of the youth with epilepsy (YWE) (50%) were females, mean age was 11.9 ± 2.8 years and years of education were 5.6 ± 2.9. All 15 YPNES and over half of their families had comorbid psychological problems whilst rates of personal and family psychiatric histories were much lower in YWE. Well over half of YPNES reported experiencing life adversities while one fourth of YWE reported these types of experiences. Significant differences were observed between YPNES and YWE on TSCC Overt Dissociation (p < 0.003), Dissociation (p < 0.009), and Depression (p < 0.001) scales, with YWE producing lower scores. When the six target variables were condensed into one principal component, the global TSCC score was lower in the epilepsy group, even after adjusting for potential effects age, seizure frequency and intellectual quotient. ConclusionsThe current study’s results indicate that YPNES present with comparably higher self-reported symptoms of depression and dissociation than YWE.