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Late onset psychogenic nonepileptic attacks

From West of Scotland Regional Epilepsy Service (R.D., M.O., E.M.), Institute of Neurological Sciences, Southern General Hospital, Glasgow; and Department of Psychiatry (A.P.), Hairmyres Hospital, East Kilbride, Scotland.

Address correspondence and reprint requests to Dr. R. Duncan, Department of Neurology, Southern General Hospital, Glasgow G51 4TF, Scotland.

Objective: To investigate differences between groups of patients with early vs late onset psychogenic nonepileptic attacks (PNEA).

Methods: The authors compared patients with onset of PNEA after age 55 years (n = 26) to patients whose onset of PNEA was before age 55 years (n = 241). The authors examined sociodemographic variables, factors potentially predisposing to PNEA, clinical semiology, and medical and psychiatric background.

Results: Patients with late onset PNEA were more likely to be male (p = 0.029) (p values are quoted uncorrected for multiple comparisons). They were less likely to report antecedent sexual abuse (p = 0.008), and more likely to have severe physical health problems (p < 0.001) and to report health-related traumatic experiences (p < 0.0001). There were no clear differences in PNEA clinical semiology. There was a trend to better baseline mental health in the late onset group.

Conclusions: The data suggest a distinct subgroup of patients with late onset psychogenic nonepileptic attacks, in whom psychological trauma related to poor physical health plays a prominent role.

Editorial, see page 1620

See also pages 1727 and 1730

Disclosure: The authors report no conflicts of interest.

Received November 9, 2005. Accepted in final form April 3, 2006.

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