Change in illness perception is associated with short-term seizure burden outcome following video-EEG confirmation of psychogenic nonepileptic seizures
| Autor: | Robert L. Collins, Callie B. Dunn, Melissa Fadipe, David K. Chen, Holly C. Rutherford, Shirine Majmudar, Aarthi Ram |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Time Factors Video eeg Video Recording Electroencephalography Affect (psychology) Illness perceptions 03 medical and health sciences Behavioral Neuroscience Epilepsy 0302 clinical medicine Cost of Illness Seizures Surveys and Questionnaires Humans Medicine Psychogenic disease 030212 general & internal medicine Aged medicine.diagnostic_test business.industry Significant difference Middle Aged medicine.disease Psychophysiologic Disorders Social Perception Neurology Female Neurology (clinical) business Attribution 030217 neurology & neurosurgery Clinical psychology |
| Zdroj: | Epilepsy & Behavior. 83:186-191 |
| ISSN: | 1525-5050 |
| Popis: | Objectives We aimed to evaluate whether potential changes in the patient's illness perception can significantly influence short-term seizure burden following video-electroencephalography (EEG) confirmation/explanation of psychogenic nonepileptic seizures (PNES). Methods Patients with PNES were dichotomized to two groups based on a five-point Symptom Attribution Scale: (a) those who prior to diagnosis perceived their seizures to be solely (“5”) or mainly (“4”) physical in origin (physical group) and (b) the remainder of patients with PNES (psychological group). The physical group (n = 32), psychological group (n = 40), and group with epilepsy (n = 26) also completed the Brief Illness Perception Questionnaire (BIPQ) prior to diagnosis, and were followed up at 3 months as well as at 6 months postdiagnosis. Results At 3 months postdiagnosis, the physical group experienced significantly greater improvement in seizure intensity (p = 0.002) and seizure frequency (p = 0.016) when compared with the psychological group. The physical group was significantly more likely to have modified their symptom attribution toward a greater psychological role to their seizures (p = 0.002), and their endorsement on the BIPQ item addressing “consequences” (How much do your seizures affect your life?) was significantly less severe (p′ = 0.014) when compared with that of the psychological group and the group with epilepsy. At 6 months postdiagnosis, the physical group continued to experience significantly greater improvement in seizure intensity (p = 0.007) while their seizure frequency no longer reached significant difference (p = 0.078) when compared with the psychological group. The physical group continued to be significantly more likely to have modified their symptom attribution toward a greater psychological role to their seizures (p = 0.005), and their endorsement on the BIPQ item addressing “consequences” remained significantly less severe (p′ = 0.037) when compared with the psychological group and the group with epilepsy. Conclusions Among patients with PNES, prediagnosis perception of seizures as “solely” or “mainly” physical in cause may be associated with greater likelihood of early postdiagnosis improvement in seizure burden. Within this physical group postdiagnosis, we uncovered preliminary evidence for significantly greater attribution toward psychological roles in seizures as well as reduction in cognitive distortion surrounding the adverse consequences of seizures. These findings portend particular impact of such changes in illness perception for this group. |
| Databáze: | OpenAIRE |
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