Psychiatric diagnoses and clinical aspects of pseudoseizures subjects.

D`ALESSIO L, GIAGANTE B, SILVA W, KOCHEN S.

Buenos Aires

Congreso; 24th International Epilepsy Congress; 2001

International League Against Epilepsy

PSYCHIATRIC DIAGNOSES AND CLINICAL ASPECTS OF PSEUDOSEIZURES PATIENTS D´Alessio L; Giagante B; Silva W; Kochen S. Epilepsy Center, Neurology Division, “R.Mejía” Hospital. Fac Medicine, Univ. Buenos Aires. Argentina. The goal of this study was to determine current and lifetime rates of DSM IV disorders in patients with pseudoseizures, non epileptic seizures (NES), documented with video-EEG,  and determine the clinical outcome after a year of follow up. Seventeen  patients  with video-EEG documented pseudoseizures, were interviewed by a psychiatrist to determine the personal history, historical course of pseudoseizures, and  the current presence of DSM IV diagnoses in axis I and axis II. It has been anayzed: coexisting epilepsy, delay to NES diagnoses, and other psychosocial variables like social dependence, and psychiatric therapy acceptance. Most of the subjects were female, 12 patients (p) (70%), and the mean age of the p group was 33 years (12-69). Common current psychiatric diagnoses included: somatoform disorders, 8 p (46%), anxiety disorders 4 p (22%) and dissociative disorders 2 p (11%). Eight p (47%) have axis II comorbidity. Seven p (41%),  had coexisting epilepsy. The mean delay to pseudoseizures diagnosis was 9 years (1-30).  Ten p (59%) accepted and received psychiatry or psychological therapy. At follow up 4 p (23,5%) were free of NES. Pseudoseizures subjects presented specially high rates of some psychiatric disorders; somatoform, dissociative and anxiety disorder, in axis I, and borderline personality disorder, and dependent personality disorder in axis II.The group with favorable outcome was associated with leading an independent life and psychological and psychiatric therapy.