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Depression and symptoms affect quality of life in psychogenic nonepileptic seizures

From the Departments of Neurology and Psychiatry (W.C.L.), Rhode Island Hospital, Brown Medical School, Providence; and Brown University (S.S.), Providence, RI.

Address correspondence and reprint requests to Dr. W. Curt LaFrance, Jr., Rhode Island Hospital, 593 Eddy Street, Potter 3, Providence, RI 02903 William_LaFrance_Jr{at}Brown.edu

Background: In patients with active epilepsy, adverse medication effects and severity of depression are correlated with health-related quality of life, but seizure frequency is not. We sought to examine if the same pattern exists in patients with psychogenic nonepileptic seizures (PNES).

Methods: We administered seizure calendars, quality of life (QOL) scales, depression scales, and symptom checklists to 49 patients with video EEG–confirmed PNES. Data analysis consisted of performing Pearson correlation coefficients, scatter plots, and t tests.

Results: Depression and symptom scores significantly increased as health-related QOL scores decreased (partial correlation coefficient r = –0.73 for both comparisons), whereas seizure count was nonsignificant (partial correlation coefficient r = –0.19).

Conclusions: As is seen in epilepsy, patients with psychogenic nonepileptic seizures demonstrate that higher depressive symptoms and somatic symptoms are independently related to worsening quality of life (QOL); however, seizure frequency is not. Seizure frequency is an important focus in patient care and treatment trials. The findings underscore the importance of, along with seizure counts, also examining QOL, depression, and somatic symptoms in patients with seizures.

Abbreviations: AED = antiepileptic drug; AEP = Adverse Events Profile; BDI = Beck Depression Inventory; DSM-IV = Diagnostic and Statistical Manual of Mental Disorders, 4th edition; HRQOL = health-related QOL; NPE = neuropsychiatric examination; PNES = psychogenic nonepileptic seizures; QOL = quality of life; QOLIE-31 = Quality of Life in Epilepsy–31; RIH = Rhode Island Hospital; SCL-90 = Symptom Checklist–90; vEEG = video EEG.

Disclosure: Author disclosures are provided at the end of the article.

Received February 12, 2009. Accepted in final form April 17, 2009.

This article has been cited by other articles:

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