title: Psychogenic nonepileptic seizures: characterization of two distinct patient profiles on the basis of trauma history.
abstract: This prospective study investigated and compared psychiatric features of 25 consecutive patients with psychogenic nonepileptic seizures (PNES) on the basis of presence of reported trauma. The "trauma" group comprised 19 patients (76%) and the "no-trauma" group comprised 6 patients (34%). We compared history of PNES, psychiatric comorbidity, alexithymia, and symptoms of dissociation. The study clearly characterized two distinct profiles of patients with PNES on the basis of trauma history. Patients with trauma had at least one psychiatric comorbidity or antecedent (vs 0% in the no-trauma group NT, P<0.001) and a higher median score of dissociation (P<0.001). Patients without trauma had more frequent "frustration situations" as a factor triggering PNES and subsequent sick leaves as perpetuating factors (P=0.001). Trauma antecedents correlated with a high rate of psychiatric comorbidity and a strong dissociative mechanism. Patients without trauma had no psychiatric comorbidity and a weaker dissociative mechanism.
authors.affiliation: CSAPA (Health Care Centre of Accompaniment and Prevention in Addictology), University Hospital of Nancy, Nancy, France. coralinehingray@hotmail.com
authors.forename: C
authors.initials: C
authors.lastname: Hingray
authors.forename: L
authors.initials: L
authors.lastname: Maillard
authors.forename: C
authors.initials: C
authors.lastname: Hubsch
authors.forename: J-P
authors.initials: JP
authors.lastname: Vignal
authors.forename: F
authors.initials: F
authors.lastname: Bourgognon
authors.forename: V
authors.initials: V
authors.lastname: Laprevote
authors.forename: J
authors.initials: J
authors.lastname: Lerond
authors.forename: H
authors.initials: H
authors.lastname: Vespignani
authors.forename: R
authors.initials: R
authors.lastname: Schwan
mesh_terms: D000328:Adult; D003291:Conversion Disorder / Q000150:complications / Q000209:etiology*; D004569:Electroencephalography; D004827:Epilepsy / Q000150:complications / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011602:Psychophysiologic Disorders / Q000150:complications / Q000209:etiology* / Q000523:psychology*; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D014947:Wounds and Injuries / Q000150:complications* / Q000523:psychology; D055815:Young Adult