Abstracts

Rationale: Psychogenic non-epileptic seizures (PNES) are one of the most common conversion disorders affecting over 300,000 patients in the US alone. They resemble epileptic seizures but they do not have electrophysiologic (EEG) correlates. It is thought that pathological responses to stressors are the origin of PNES with the most common end-effect of the faulty response to stress being either appearance or recurrence of the events. Presentations of PNES have been linked to psychopathology (Griffith, Szaflarski et al. 2007). . Psychometric tools including the Personality Assessment Inventory (PAI) have proven helpful in delineating the psychopathology in PNES. Although PAI profile of patients with PNES has been compared to patients with epilepsy, it has never been compared to population norms. Thus, the goal of this study is to compare the personality traits of patients with well characterized PNES to population norms. Methods: All patients admitted to the epilepsy monitoring unit (EMU) at UAB between 2/1/13 and 4/30/14 were approached for participation in the study. Of 122 patients who consented to participate 39 were diagnosed with PNES, 41 with epilepsy, 42 with either mixed diagnosis or had a non-diagnostic study. Of the 39 PNES patients, 29 completed all questionnaires and their responses were included in the final analysis after assessing for validity of indices of PAI. Only data collected prior to patients receiving their diagnosis were analyzed. Comparison was made to PAI normative data derived from the US census-matched standardization sample (Morey 2007). Independent samples t-test was used to compare PAI estimates for the PNES sample with the population-based norms. Results: Compared to population norms, the PNES group was found to have more somatic complaints (PAI/somatic complaints, p<0.001, 98T), more anxiety and fears surrounding certain situations (PAI/anxiety scale, p<0.001, 85T; Anxiety-related disorders, p<0.001, 86T). The PNES group is likely to have manic/depressive tendency (PAI/depression p<0.001, 84T; PAI/mania p<0.001, 78T), higher level of paranoia (PAI/paranoia p<0.001, 83T), higher borderline features (PAI/borderline p<0.001, 82T) and antisocial features (PAI/antisocial p<<0.001, 76T). PNES patients are likely to have met criteria of drug substance abuse at some point in their life (PAI/drug problem scale, p<0.001, 75T). Conclusions: Our data confirm that patients with PNES have overall worse psychosocial functioning compared to population norms. These findings support the need for early recognition of coexisting psychiatric comorbidities in patients with PNES and the need for further research to devise best treatment strategies.