title: Impact of family functioning on quality of life in patients with psychogenic nonepileptic seizures versus epilepsy.
abstract: OBJECTIVE
  To evaluate different contributions of aspects of family functioning (FF) on health-related quality of life (HRQOL) in patients with psychogenic nonepileptic seizures (PNES) versus epileptic seizures (ES).
  
  
  METHODS
  Forty-five participants with PNES and 32 with ES completed self-report measures of FF (Family Assessment Device; FAD), HRQOL (Quality of Life in Epilepsy-31), and depression (Beck Depression Inventory-II; BDI-II). The FAD is a self-report questionnaire that assesses FF along six dimensions and general functioning. Regression analyses were used to evaluate the contribution of FF to HRQOL above and beyond the effects of disease severity and depression.
  
  
  RESULTS
  Mean Family General Functioning fell in the unhealthy range in participants with ES or PNES. On further analysis, male participants in each group endorsed unhealthy levels of FF compared to female participants. Patients with PNES reported poorer HRQOL and greater depressive symptoms compared to ES participants; there were no gender differences in HRQOL. Regression analyses indicated that the FAD Roles subscale predicted reduced HRQOL in patients with PNES after controlling for illness duration, seizure frequency, and depression. After controlling for the same factors, Communication and Affective Involvement subscales scores predicted HRQOL in ES participants.
  
  
  CONCLUSIONS
  Family dysfunction was reported in both ES and PNES participants, but greater family dysfunction was experienced by male participants in both groups. Aspects of FF predicted HRQOL in patients with PNES and ES differentially. FF may be an important treatment target to enhance coping in these groups, although the treatments may need to target different aspects of FF in PNES versus ES.
authors.affiliation: Department of Psychiatry, Rhode Island Hospital, Providence, Rhode Island 02903, USA. William_LaFrance_Jr@Brown.edu
authors.forename: W Curt
authors.initials: WC
authors.lastname: LaFrance
authors.forename: Michael L
authors.initials: ML
authors.lastname: Alosco
authors.forename: Jennifer Duncan
authors.initials: JD
authors.lastname: Davis
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Tremont
authors.forename: Christine E
authors.initials: CE
authors.lastname: Ryan
authors.forename: Gabor I
authors.initials: GI
authors.lastname: Keitner
authors.forename: Ivan W
authors.initials: IW
authors.lastname: Miller
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Blum
mesh_terms: D000328:Adult; D000339:Affect; D003142:Communication; D003863:Depression / Q000523:psychology; D004569:Electroencephalography; D004827:Epilepsy / Q000523:psychology*; D005195:Family Relations; D005260:Female; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012640:Seizures / Q000523:psychology*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome