title: Psychiatric comorbidity in veterans with psychogenic seizures.
abstract: Psychogenic non-epileptic seizures (PNES) are frequently encountered in epilepsy monitoring units (EMU) at Veterans Affairs Medical Centers (VAMCs) and cause significant long-term disability. An understanding of psychiatric factors associated with PNES could aid in earlier diagnosis and treatment. We studied 50 consecutive veterans diagnosed with PNES and 37 veterans diagnosed with epileptic seizures (ES), evaluated at a VAMC EMU. We reviewed all available mental health evaluations prior to EMU evaluation. Univariate comparisons included axis I diagnoses, axis II diagnoses, and psychiatric hospitalizations. Predictive models of seizure classification were evaluated by logistic regression. A diagnosis of post-traumatic stress disorder (PTSD) preceded the diagnosis of PNES in 58% of patients and the diagnosis of ES in 13.5% (p<0.001). On logistic regression, PTSD was the only significant psychiatric diagnosis (odds ratio 9.2). Major depression and alcohol abuse were common diagnoses but did not differentiate PNES and ES groups.
authors.affiliation: Portland Veterans Affairs Medical Center, Portland, OR, USA. Salinsky@ohsu.edu
authors.forename: Martin
authors.initials: M
authors.lastname: Salinsky
authors.forename: Collette
authors.initials: C
authors.lastname: Evrard
authors.forename: Daniel
authors.initials: D
authors.lastname: Storzbach
authors.forename: Mary Jo
authors.initials: MJ
authors.lastname: Pugh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003291:Conversion Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D003937:Diagnosis, Differential; D004185:Disability Evaluation; D005260:Female; D006787:Hospitals, Veterans; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D011602:Psychophysiologic Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D012640:Seizures / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D014728:Veterans; D055815:Young Adult