title: Psychological problems and clinical outcomes of children with psychogenic non-epileptic seizures.
abstract: OBJECTIVE
  Our purpose was to investigate psychological problems and clinical outcomes in children with psychogenic non-epileptic seizures (PNES).
  
  
  METHODS
  We retrospectively reviewed the data of 25 patients who were diagnosed with PNES between 2006 and 2012.
  
  
  RESULTS
  Twenty-five children with PNES, aged 8 to 19 years (mean 13.82), were referred to psychiatrists for psychiatric assessment. On their initial visit, 72% of patients had comorbid psychological problems, including depression, anxiety, conduct disorder, adjustment disorder, Attention Deficit Hyperactivity Disorder, schizophrenia, and bipolar disorder. Among these, depression was the most frequent (36%). Predisposing and triggering factors included familial distress (40%), social distress (24%), and specific events (20%). The following treatment was advised based on the results of the initial psychological assessment: 3 patients regularly visited psychiatric clinic to assess their clinical status without treatment, nine underwent psychotherapy, and 13 received a combination of psychotherapy and psychopharmacological therapy. At the mean follow-up of 31.5 months after diagnosis, 20 patients (80%) were event-free at follow-up, three (12%) showed reduced frequency, and two (8%) experienced persistent symptoms.
  
  
  CONCLUSIONS
  The outcomes of PNES in children are much better than those in adults, despite a high rate of psychological comorbidities.
authors.affiliation: Department of Pediatrics, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
authors.forename: Yoon Young
authors.initials: YY
authors.lastname: Yi
authors.affiliation: Division of Pediatric Neurology, Department of Pediatrics, Pediatric Epilepsy Clinic, Severance Children's Hospital, Epilepsy Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Heung Dong
authors.initials: HD
authors.lastname: Kim
authors.affiliation: Division of Pediatric Neurology, Department of Pediatrics, Pediatric Epilepsy Clinic, Severance Children's Hospital, Epilepsy Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Joon Soo
authors.initials: JS
authors.lastname: Lee
authors.affiliation: Division of Child and Adolescent Psychiatry, Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Keun-Ah
authors.initials: KA
authors.lastname: Cheon
authors.affiliation: Division of Pediatric Neurology, Department of Pediatrics, Pediatric Epilepsy Clinic, Severance Children's Hospital, Epilepsy Research Institute, Yonsei University College of Medicine, Seoul, Korea. hipo0207@yuhs.ac.
authors.forename: Hoon-Chul
authors.initials: HC
authors.lastname: Kang
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000453:epidemiology; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology; D003866:Depressive Disorder / Q000453:epidemiology / Q000523:psychology; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D008875:Middle Aged; D011602:Psychophysiologic Disorders / Q000175:diagnosis* / Q000523:psychology*; D011613:Psychotherapy; D012189:Retrospective Studies; D012640:Seizures / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Seizure; children; psychological