Abstracts

Despite ample research to differentiate patients with PNES from those with epilepsy, little information is known about prognosis and effective treatment of PNES. A recent study suggests three types of PNES patients, based on a self-report psychopathology measure¹. To date, only that investigation offers data on different types of PNES on the basis of an objective psychological measure.of this investigation is to add to this preliminary area of research using the NEO-PI-R, a well developed measure of the well-validated five-factor model of personality in order to add to a foundation for future outcomes and treatment research. All consecutive patients admitted for inpatient video-EEG monitoring completed the NEO-PI-R for the study. Patients were also routinely evaluated with a neuropsychological test battery and the MMPI-2. This investigation is based on 74 consecutive patients with PNES diagnosed with video-EEG monitoring. Three clusters were formed (1) Very high Neuroticism, Low Extraversion, Low Openness, High Agreeableness, Low Conscientiousness; (2) Average on all domains; (3) Very high Neuroticism, Average Extraversion, Low Openness, Low Agreeableness, Average Conscientiousness. No differences between clusters were seen on demographic variables, seizure variables, or psychosocial variables. Generally, clusters 1 and 3 exhibited more severe psychopathology on the MMPI-2. Cluster 2 exhibited a focused profile consistent with somatoform disorder. Clusters 1 and 3 differed significantly on neurocognitive testing, with cluster 1 significantly lower than cluster 3 in memory functioning. Cluster 2 was generally average in all neurocognitive domains and significantly higher than cluster 1. None of the clusters in this sample is identical to a previous report ¹, though there are similar features, such as high Neuroticism, low Extraversion, and low Agreeablenss. The prior study used a different measure of personality, which appeared more focused on abnormal variants of personality traits. The three clusters here are associated with differences in psychopathology and neurocognitive functioning as well, information that helps validate the different clusters formed by personality variables alone. [italic]These[/italic] [italic]results therefore, support the existence of clusters of types of PNES patients, and we suggest that future research should consider these clusters in order to design more successful interventions.[/italic]
¹., Pukrop R., Bauer J., et al. Multidimensional assessment of personality in patients with psychogenic non-epileptic seizures. [italic]J Neurol Neurosurg Psychiatry[/italic] 2004; : 743-748. (Supported by the Epilepsy Foundation through the generous support of the American Epilepsy Society.)