A South African review of routinely-collected health data of psychogenic nonepileptic seizure patients referred to psychiatrists in Johannesburg
| Autor: | Laila Paruk, Angelo Philippides, Joanna Taylor, G. Jonsson |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Generalized anxiety disorder Adolescent South Africa Young Adult 03 medical and health sciences Behavioral Neuroscience Epilepsy 0302 clinical medicine Seizures medicine Functional neurological symptom disorder Humans Psychogenic disease 030212 general & internal medicine Psychiatry Aged Retrospective Studies Depressive Disorder Major business.industry Psychiatric assessment Electroencephalography Middle Aged medicine.disease Substance abuse Neurology Major depressive disorder Anxiety Female Neurology (clinical) medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | Epilepsy & Behavior. 114:107578 |
| ISSN: | 1525-5050 |
| DOI: | 10.1016/j.yebeh.2020.107578 |
| Popis: | Patients with psychogenic nonepileptic seizures (PNES) are often referred to psychiatrists for treatment of functional neurological symptom disorder (FNSD). However, not all patients with FNSD have an identified psychiatric comorbidity [1] . The aim of this observational study was to characterize the clinical and psychiatric features of patients with PNES from Johannesburg, South Africa, where a high frequency of PNES has been reported [2] , and compare these findings to other reports. We hypothesized that patient outcomes regarding treatment adherence and episode frequency would improve when treated within a closed multidisciplinary team. The data included a retrospective record review of patients diagnosed with PNES from an epilepsy monitoring unit and referred for psychiatric assessment and treatment between November 2013 and July 2017. Fifty-nine cases met the criteria for the study. There were 7 male and 52 female participants, aged between 14 and 72 years (M = 33.76, SD = 13.88). The most frequently reported comorbid symptoms were anxiety (90%); dissociative symptoms (51%); headaches (76%) and gastrointestinal symptoms (36%). Important patient characteristics included past substance abuse (76%); impaired attachment (86%); past trauma (69%) and sexual trauma (29%). Generalized anxiety disorder (76%), major depressive disorder (64%) and PTSD (22%) were the most prevalent psychiatric diagnoses. After receiving psychiatric treatment, 47% of patients experienced a decrease in the frequency of episodes, while 86% became aware of the precipitants of their episodes. Psychiatric data can valuably inform current theories of PNES management. This study contributes to the understanding of comorbid, aetiological, and prognostic factors that are crucial to refining coherent models that will guide practice. |
| Databáze: | OpenAIRE |
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