Psychiatric comorbidity in veterans with psychogenic seizures
Abstract Psychogenic non-epileptic seizures (PNES) are frequently encountered in epilepsy monitoring units (EMU) at Veterans Affairs Medical Centers (VAMCs) and cause significant long-term disability. An understanding of psychiatric factors associated with PNES could aid in earlier diagnosis and tre...
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| Veröffentlicht in: | Epilepsy & behavior 2012-11, Vol.25 (3), p.345-349 |
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| creator | Salinsky, Martin Evrard, Collette Storzbach, Daniel Pugh, Mary Jo |
| description | Abstract Psychogenic non-epileptic seizures (PNES) are frequently encountered in epilepsy monitoring units (EMU) at Veterans Affairs Medical Centers (VAMCs) and cause significant long-term disability. An understanding of psychiatric factors associated with PNES could aid in earlier diagnosis and treatment. We studied 50 consecutive veterans diagnosed with PNES and 37 veterans diagnosed with epileptic seizures (ES), evaluated at a VAMC EMU. We reviewed all available mental health evaluations prior to EMU evaluation. Univariate comparisons included axis I diagnoses, axis II diagnoses, and psychiatric hospitalizations. Predictive models of seizure classification were evaluated by logistic regression. A diagnosis of post-traumatic stress disorder (PTSD) preceded the diagnosis of PNES in 58% of patients and the diagnosis of ES in 13.5% (p < 0.001). On logistic regression, PTSD was the only significant psychiatric diagnosis (odds ratio 9.2). Major depression and alcohol abuse were common diagnoses but did not differentiate PNES and ES groups. |
| doi_str_mv | 10.1016/j.yebeh.2012.07.013 |
| format | Article |
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An understanding of psychiatric factors associated with PNES could aid in earlier diagnosis and treatment. We studied 50 consecutive veterans diagnosed with PNES and 37 veterans diagnosed with epileptic seizures (ES), evaluated at a VAMC EMU. We reviewed all available mental health evaluations prior to EMU evaluation. Univariate comparisons included axis I diagnoses, axis II diagnoses, and psychiatric hospitalizations. Predictive models of seizure classification were evaluated by logistic regression. A diagnosis of post-traumatic stress disorder (PTSD) preceded the diagnosis of PNES in 58% of patients and the diagnosis of ES in 13.5% (p < 0.001). On logistic regression, PTSD was the only significant psychiatric diagnosis (odds ratio 9.2). Major depression and alcohol abuse were common diagnoses but did not differentiate PNES and ES groups.</description><identifier>ISSN: 1525-5050</identifier><identifier>EISSN: 1525-5069</identifier><identifier>DOI: 10.1016/j.yebeh.2012.07.013</identifier><identifier>PMID: 23103308</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Classification ; Comorbidity ; Conversion Disorder - diagnosis ; Conversion Disorder - epidemiology ; Conversion Disorder - psychology ; Depression ; Diagnosis, Differential ; Disability Evaluation ; Drug abuse ; Epilepsy ; Female ; Hospitals, Veterans ; Humans ; Logistic Models ; Longitudinal Studies ; Male ; Mental disorders ; Mental Disorders - diagnosis ; Mental Disorders - epidemiology ; Middle Aged ; Neurology ; Post-traumatic stress disorder ; Psychogenic seizures ; Psychophysiologic Disorders - diagnosis ; Psychophysiologic Disorders - epidemiology ; Psychophysiologic Disorders - psychology ; Regression analysis ; Seizures ; Seizures - diagnosis ; Seizures - epidemiology ; Seizures - psychology ; Veterans ; Young Adult</subject><ispartof>Epilepsy & behavior, 2012-11, Vol.25 (3), p.345-349</ispartof><rights>2012</rights><rights>Published by Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c480t-ace212e5cad4a4e8a338b566d9fc2cb3b2763baf6c6d58431f0c87064a5c28ff3</citedby><cites>FETCH-LOGICAL-c480t-ace212e5cad4a4e8a338b566d9fc2cb3b2763baf6c6d58431f0c87064a5c28ff3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S152550501200488X$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,65309</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23103308$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Salinsky, Martin</creatorcontrib><creatorcontrib>Evrard, Collette</creatorcontrib><creatorcontrib>Storzbach, Daniel</creatorcontrib><creatorcontrib>Pugh, Mary Jo</creatorcontrib><title>Psychiatric comorbidity in veterans with psychogenic seizures</title><title>Epilepsy & behavior</title><addtitle>Epilepsy Behav</addtitle><description>Abstract Psychogenic non-epileptic seizures (PNES) are frequently encountered in epilepsy monitoring units (EMU) at Veterans Affairs Medical Centers (VAMCs) and cause significant long-term disability. An understanding of psychiatric factors associated with PNES could aid in earlier diagnosis and treatment. We studied 50 consecutive veterans diagnosed with PNES and 37 veterans diagnosed with epileptic seizures (ES), evaluated at a VAMC EMU. We reviewed all available mental health evaluations prior to EMU evaluation. Univariate comparisons included axis I diagnoses, axis II diagnoses, and psychiatric hospitalizations. Predictive models of seizure classification were evaluated by logistic regression. A diagnosis of post-traumatic stress disorder (PTSD) preceded the diagnosis of PNES in 58% of patients and the diagnosis of ES in 13.5% (p < 0.001). On logistic regression, PTSD was the only significant psychiatric diagnosis (odds ratio 9.2). Major depression and alcohol abuse were common diagnoses but did not differentiate PNES and ES groups.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Classification</subject><subject>Comorbidity</subject><subject>Conversion Disorder - diagnosis</subject><subject>Conversion Disorder - epidemiology</subject><subject>Conversion Disorder - psychology</subject><subject>Depression</subject><subject>Diagnosis, Differential</subject><subject>Disability Evaluation</subject><subject>Drug abuse</subject><subject>Epilepsy</subject><subject>Female</subject><subject>Hospitals, Veterans</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Mental disorders</subject><subject>Mental Disorders - diagnosis</subject><subject>Mental Disorders - epidemiology</subject><subject>Middle Aged</subject><subject>Neurology</subject><subject>Post-traumatic stress disorder</subject><subject>Psychogenic seizures</subject><subject>Psychophysiologic Disorders - diagnosis</subject><subject>Psychophysiologic Disorders - epidemiology</subject><subject>Psychophysiologic Disorders - psychology</subject><subject>Regression analysis</subject><subject>Seizures</subject><subject>Seizures - diagnosis</subject><subject>Seizures - epidemiology</subject><subject>Seizures - psychology</subject><subject>Veterans</subject><subject>Young Adult</subject><issn>1525-5050</issn><issn>1525-5069</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU1v1DAQhi0Eoh_wC5BQjlw2zNhx4j0UCVWlIFUCqUXiZjmTCeslmyx2UhR-PQ7b9tBLNYeZw_POSM8I8QYhR8Dy_TafueZNLgFlDlUOqJ6JY9RSrzSU6-cPs4YjcRLjFgBRK3wpjqRCUArMsTj7FmfaeDcGTxkNuyHUvvHjnPk-u-WRg-tj9sePm2y_gMNP7hMY2f-dAsdX4kXrusiv7_qp-P7p4ub88-rq6-WX849XKyoMjCtHLFGyJtcUrmDjlDK1Lstm3ZKkWtWyKlXt2pLKRptCYQtkKigLp0matlWn4t1h7z4MvyeOo935SNx1rudhihZllQrMev00ihorMKBkQtUBpTDEGLi1--B3LswWwS6K7db-V2wXxRYqmxSn1Nu7A1O94-Yhc-80AWcHgJORW8_BRvLcEzc-MI22GfwTBz48ylPnk3XX_eKZ43aYQp9kW7QxZez18uXlySgBCmN-qH-BN6LG</recordid><startdate>20121101</startdate><enddate>20121101</enddate><creator>Salinsky, Martin</creator><creator>Evrard, Collette</creator><creator>Storzbach, Daniel</creator><creator>Pugh, Mary Jo</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7TK</scope></search><sort><creationdate>20121101</creationdate><title>Psychiatric comorbidity in veterans with psychogenic seizures</title><author>Salinsky, Martin ; Evrard, Collette ; Storzbach, Daniel ; Pugh, Mary Jo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c480t-ace212e5cad4a4e8a338b566d9fc2cb3b2763baf6c6d58431f0c87064a5c28ff3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Classification</topic><topic>Comorbidity</topic><topic>Conversion Disorder - diagnosis</topic><topic>Conversion Disorder - epidemiology</topic><topic>Conversion Disorder - psychology</topic><topic>Depression</topic><topic>Diagnosis, Differential</topic><topic>Disability Evaluation</topic><topic>Drug abuse</topic><topic>Epilepsy</topic><topic>Female</topic><topic>Hospitals, Veterans</topic><topic>Humans</topic><topic>Logistic Models</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Mental disorders</topic><topic>Mental Disorders - diagnosis</topic><topic>Mental Disorders - epidemiology</topic><topic>Middle Aged</topic><topic>Neurology</topic><topic>Post-traumatic stress disorder</topic><topic>Psychogenic seizures</topic><topic>Psychophysiologic Disorders - diagnosis</topic><topic>Psychophysiologic Disorders - epidemiology</topic><topic>Psychophysiologic Disorders - psychology</topic><topic>Regression analysis</topic><topic>Seizures</topic><topic>Seizures - diagnosis</topic><topic>Seizures - epidemiology</topic><topic>Seizures - psychology</topic><topic>Veterans</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Salinsky, Martin</creatorcontrib><creatorcontrib>Evrard, Collette</creatorcontrib><creatorcontrib>Storzbach, Daniel</creatorcontrib><creatorcontrib>Pugh, Mary Jo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Neurosciences Abstracts</collection><jtitle>Epilepsy & behavior</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Salinsky, Martin</au><au>Evrard, Collette</au><au>Storzbach, Daniel</au><au>Pugh, Mary Jo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Psychiatric comorbidity in veterans with psychogenic seizures</atitle><jtitle>Epilepsy & behavior</jtitle><addtitle>Epilepsy Behav</addtitle><date>2012-11-01</date><risdate>2012</risdate><volume>25</volume><issue>3</issue><spage>345</spage><epage>349</epage><pages>345-349</pages><issn>1525-5050</issn><eissn>1525-5069</eissn><abstract>Abstract Psychogenic non-epileptic seizures (PNES) are frequently encountered in epilepsy monitoring units (EMU) at Veterans Affairs Medical Centers (VAMCs) and cause significant long-term disability. An understanding of psychiatric factors associated with PNES could aid in earlier diagnosis and treatment. We studied 50 consecutive veterans diagnosed with PNES and 37 veterans diagnosed with epileptic seizures (ES), evaluated at a VAMC EMU. We reviewed all available mental health evaluations prior to EMU evaluation. Univariate comparisons included axis I diagnoses, axis II diagnoses, and psychiatric hospitalizations. Predictive models of seizure classification were evaluated by logistic regression. A diagnosis of post-traumatic stress disorder (PTSD) preceded the diagnosis of PNES in 58% of patients and the diagnosis of ES in 13.5% (p < 0.001). On logistic regression, PTSD was the only significant psychiatric diagnosis (odds ratio 9.2). Major depression and alcohol abuse were common diagnoses but did not differentiate PNES and ES groups.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>23103308</pmid><doi>10.1016/j.yebeh.2012.07.013</doi><tpages>5</tpages></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Classification Comorbidity Conversion Disorder - diagnosis Conversion Disorder - epidemiology Conversion Disorder - psychology Depression Diagnosis, Differential Disability Evaluation Drug abuse Epilepsy Female Hospitals, Veterans Humans Logistic Models Longitudinal Studies Male Mental disorders Mental Disorders - diagnosis Mental Disorders - epidemiology Middle Aged Neurology Post-traumatic stress disorder Psychogenic seizures Psychophysiologic Disorders - diagnosis Psychophysiologic Disorders - epidemiology Psychophysiologic Disorders - psychology Regression analysis Seizures Seizures - diagnosis Seizures - epidemiology Seizures - psychology Veterans Young Adult |
| title | Psychiatric comorbidity in veterans with psychogenic seizures |
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