title: Biopsychosocial predictors of psychogenic non-epileptic seizures.
abstract: BACKGROUND
  Previous studies have identified numerous biological, psychological and social characteristics of persons with psychogenic non-epileptic seizures (PNES) however the strength of many of these factors have not been evaluated to determine which are predictive of the diagnosis compared to those that may only be stereotypes with limited clinical utility.
  
  
  METHODS
  A retrospective chart review of persons admitted to our epilepsy monitoring unit over a 6-year period was conducted to examine predictors of a video-EEG confirmed PNES diagnosis.
  
  
  RESULTS
  A total of 689 patients had events leading to a diagnosis, 47% (n=324) with PNES only, 12% (n=84) with PNES & Epilepsy and 41% (n=281) with Epilepsy only. Five biological predictors of a PNES only diagnosis were found; number of years with events (OR=1.10), history of head injury (OR=1.91), asthma (OR=2.94), gastro-esophageal reflux disease (OR=1.72) and pain (OR=2.25). One psychological predictor; anxiety (OR=1.72) and two social predictors; being married (OR=1.81) and history of physical/sexual abuse (OR=3.35). Two significant biological predictors of a PNES & Epilepsy diagnosis were found; migraine (OR=1.83) and gastro-esophageal reflux disease (OR=2.17).
  
  
  CONCLUSIONS
  Our findings support the importance of considering the biopsychosocial model for the diagnosis and treatment of PNES or PNES with concomitant epilepsy.
authors.affiliation: Ohio Health Riverside Methodist Hospital, 3535 Olentangy River Road, Columbus, OH 43214, United States; Ohio State University, College of Social Work, 1947 Stillman Hall, Columbus, OH 43210, United States. Electronic address: elliott.327@osu.edu.
authors.forename: John O
authors.initials: JO
authors.lastname: Elliott
authors.affiliation: Department of Neurology, Ohio State University Wexner Medical Center, 395W, 12th Avenue, 7th Floor, Columbus, OH 43210, United States. Electronic address: charyton.1@osu.edu.
authors.forename: Christine
authors.initials: C
authors.lastname: Charyton
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D004569:Electroencephalography; D005260:Female; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011602:Psychophysiologic Disorders / Q000150:complications / Q000175:diagnosis* / Q000523:psychology*; D012189:Retrospective Studies; D012640:Seizures / Q000150:complications / Q000175:diagnosis* / Q000523:psychology*; D012919:Social Behavior; D014741:Video Recording
keywords: Biological; Non-epileptic seizures; Pseudoseizures; Psychological; Social