Patients with Non-Epileptic Seizures Show Higher Levels of Alexithymia, Emotional Control and Stressful Adult Experiences Than Patients with Epilepsy and Matched Controls.
Abstract number :
2.108
Submission category :
Year :
2001
Submission ID :
2996
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
C. Dinneen, BA, Dip Psych, Department of Neuropsychology, Beaumont Hospital, Dublin, Ireland; N. Delanty, MB, Department of Neurology, Beaumont Hospital, Dublin, Ireland; V. O[ssquote] Keane, MB, Department of Psychiatry, Beaumont Hospital, Dublin, Irelan
RATIONALE: Non-epileptic seizures(NES) represent paroxysmal changes in behaviour that resemble epileptic seizures but occur without organic cause, as diagnosed on Video-EEG monitoring. NES development has been associated with various psychiatric disorders particularly those incurred by the trauma of childhood sexual abuse. This study assesses the validity of a new model (Mc Mackin, 2000) that views inability to accurately identify, reflect on and regulate emotions (alexithymia) as a key construct in the development of NES. Within this model dysfunctional emotional expression causes these individuals to express distress as physical [soquote]seizure[scquote] symptoms when confronted with the stimulus of life stress or trauma in adulthood. When these events are diagnosed as epilepsy, a set of learned behaviours, i.e. fear of epilepsy and recurrence of seizures, are considered to make the cycle of NES stronger and resistant to change.
METHODS: 26 consecutive patients presenting to a long term video-EEG monitoring unit for evaluation of seizures of unknown aetiology participated in the study. The NES group (n=8) were compared with the video-EEG diagnosed epilepsy group (n=18) and a matched control group (n=12) prior to confirmation of diagnosis (i.e. while they believed they had epilepsy). Measures used included an alexithymia scale (TAS-20), a scale of dysfunctional emotional expression (EEC), the Beck Inventories, a dissociation scale (DES-II) and a structured interview including a trauma checklist.
RESULTS: The NES group showed higher levels of alexithymia (p[lt] 0.02) than patients with epilepsy or matched controls. While the NES and epilepsy groups showed similar levels of childhood trauma, the NES group showed the highest incidence of adult trauma (p[lt] 0.01). There is a trend towards higher (dysfunctional) levels of emotional control in the NES group, compared with the epilepsy and control groups. The NES group were also significantly higher on the Dissociative Experiences Questionnaire than the comparison groups (p [lt].05).
CONCLUSIONS: These data provide support for and validate the constructs outlined in a new cognitive behavioural therapy intervention for non-epileptic seizures. They suggest that while trauma is important as a trigger in NES, the patterns of emotional expression learned in childhood may also be critical in the genesis of NES as prosposed by this model.
Support: A Galen Fellowship to D. Mc Mackin from the Irish Brain Research Foundation