Abstracts

Rationale: Major traumatic events are known to be highly prevalent among patients with Psychogenic Nonepileptic Seizures (PNES), playing a role in its psychopathology. Most of the literature has focused on physical and sexual abuse, with less being known about other risk factors. In this study, we aimed to verify if these events differ according to the patients age. Methods: Retrospective review of medical records of 146 patients (102 adults 78 female and 24 male- and 44 children 21 female and 23 male) diagnosed with PNES by VEEG from 2006 to 2012. Medical and psychiatric evaluation was analyzed regarding major stressful life events time-related with the onset or worsening of PNES.Results: In 46 adult patients (45.09%; 10 male and 36 female) it was possible to determine a time related major stress factor, without any gender difference. Other 30 (29.41%) had suggestive history of previous PTSD. Family conflicts were reported by 16 (15.68%) patients, and relevant work related issues by 10 (9.80%). Two women had onset of PNES during pregnancy, and two after miscarriage. Sexual abuse was reported by six female patients (5.88%) and physical abuse by 18 (17.64%). Psychological abuse was reported by 12 (26.08%). Regarding the pediatric population, in 32 patients (72.72%) it was possible to find a traumatic time-related event, without gender differences. An inadequate family setting was observed in 13 cases (29.5%) and a family conflict was found in other 8 (18.18%), mainly parents divorce [6 (13.43%)] and family illness (22.72%). School related issues occurred in 17 children (38.63%), mainly bullying in 10 (22.72%), learning difficulties or academic failure in 6 (13.63%). Sexual or physical abuse was reported by 8 patients (18.18%) and psychological abuse by 4 (9.09%). Sexual abuse was reported only by girls. Two patients (one adult, and one teenager) initiated PNES during incarceration. Conclusions: Our results support the high prevalence of major stressful events in patients with PNES. In this study, the type of event differs in different ages.