INVESTIGADORES
KOCHEN Sara Silvia
artículos
Título:
Psychiatric disorders in patients with psychogenic nonepileptic seizures and drug-resistant epilepsy: A study of an Argentine population
Autor/es:
LAURA SCÉVOLA, JULIA TEITELBAUM, SILVIA ODDO, ESTELA CENTURIÓN, CÉSAR FABIÁN LOIDL, SILVIA KOCHEN, LUCIANA D´ALESSIO
Revista:
EPILEPSY & BEHAVIOR (PRINT)
Editorial:
ACADEMIC PRESS INC ELSEVIER SCIENCE
Referencias:
Lugar: Amsterdam; Año: 2013 p. 155 - 160
ISSN:
1525-5050
Resumen:
Epidemiological data showthat up to 20?30% of patientswith psychogenic nonepileptic seizures (PNESs), resembling
drug-resistant epilepsy (DRE), are referred to tertiary epilepsy centers. Furthermore, both disorders present
high psychiatric comorbidity, and video-EEG is the gold standard to make differential diagnoses. In this study,we
described and compared the clinical presentation and the frequency of psychiatric disorders codified in DSMIV in
two groups of patients, one with PNESs and the other with DRE, admitted in a tertiary care epilepsy center of
Buenos Aires, Argentina.
We included 35 patients with PNESs and 49 with DRE; all were admitted in the video-EEG unit in order to confirm
an epilepsy diagnosis and determine surgical treatment possibilities. All patients underwent a neurological
and psychiatric assessment, according to standardized protocol (SCID I and II; DSM IV criteria). Student's t test
was performed to compare continuous variables and Chi square test to compare qualitative variables.
In this study, 33 (67%) patientswith DRE and 35 (100%) patients with PNESs met criteria for at least one disorder
codified in Axis I of DSM IV (p = 0.003). Differences in the frequency of psychiatric disorder presentation were
found between groups. Anxiety disorders (16.32% vs 40%; p = 0.015), trauma history (24.5% vs 48.57%; p =
0.02), posttraumatic stress disorder (4.08% vs 22.85%; p = 0.009), and personality cluster B disorders (18.37%
vs 42.86%; p = 0.02) were more frequent in the group with PNESs. Psychotic disorders were more frequent in
the group with DRE (20.4% vs 2.85%; p = 0.019). Depression was equally prevalent in both groups.
Standardized psychiatric assessment provides information that could be used by the mental health professional
who receives the referral in order to improve quality of care and smooth transitions to proper PNES treatment,
which should include a multidisciplinary approach including neurology and psychiatry.