title: Quality of life in psychogenic nonepileptic seizures and epilepsy: the role of somatization and alexithymia.
abstract: It is clear that many individuals with psychogenic nonepileptic seizures (PNESs) often present with poorer quality of life compared with those with epileptic seizures (ESs). However, the mechanisms linking seizure diagnosis to quality-of-life outcomes are much less clear. Alexithymia and somatization are emotional markers of psychological functioning that may explain these differences in quality of life. In the current study, patients from an epilepsy monitoring unit with vEEG-confirmed diagnosis of PNESs or ESs were compared on measures of alexithymia, somatization, quality of life, and a variety of demographic and medical variables. Two models using alexithymia and somatization individually as mediators of the relations between diagnosis and quality of life were tested. Results indicated that patients with PNESs had significantly poorer quality of life compared with those with ESs. Alexithymia was associated with poor quality of life in both groups but did not differentiate between diagnostic groups. Further, alexithymia did not mediate the relationship between diagnosis and quality of life. Somatization was associated with poor quality of life, and patients with PNESs reported greater somatization compared with patients with ESs. Somatization also significantly mediated the relationship between diagnosis and quality of life. In conclusion, somatization may be one mechanism affecting poor quality of life among patients with PNESs compared with ESs and should be a target of comprehensive treatments for PNESs. Alexithymia proved to be an important factor impacting quality of life in both groups and should also be targeted in treatment for patients with PNESs and patients with ESs.
authors.affiliation: Arizona State University, Department of Psychology, 651 E. University Drive, Tempe, AZ 86287, USA.
authors.forename: Laurie Dempsey
authors.initials: LD
authors.lastname: Wolf
authors.affiliation: Mayo Clinic Arizona, Department of Biostatistics, 13400 E. Shea Blvd., Scottsdale, AZ 85259, USA.
authors.forename: Joseph G
authors.initials: JG
authors.lastname: Hentz
authors.affiliation: Mayo Clinic Arizona, Department of Neurology, 5777 E. Mayo Blvd., Phoenix, AZ 85054, USA.
authors.forename: Kristine S
authors.initials: KS
authors.lastname: Ziemba
authors.affiliation: Mayo Clinic Arizona, Division of Psychology, 13400 E. Shea Blvd., Scottsdale, AZ 85259, USA.
authors.forename: Kristin A
authors.initials: KA
authors.lastname: Kirlin
authors.affiliation: Mayo Clinic Arizona, Department of Neurology, 5777 E. Mayo Blvd., Phoenix, AZ 85054, USA.
authors.forename: Katherine H
authors.initials: KH
authors.lastname: Noe
authors.affiliation: Mayo Clinic Arizona, Department of Neurology, 5777 E. Mayo Blvd., Phoenix, AZ 85054, USA.
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Hoerth
authors.affiliation: Mayo Clinic Arizona, Department of Neurology, 5777 E. Mayo Blvd., Phoenix, AZ 85054, USA.
authors.forename: Amy Z
authors.initials: AZ
authors.lastname: Crepeau
authors.affiliation: Mayo Clinic Arizona, Department of Neurology, 5777 E. Mayo Blvd., Phoenix, AZ 85054, USA.
authors.forename: Joseph I
authors.initials: JI
authors.lastname: Sirven
authors.affiliation: Mayo Clinic Arizona, Department of Neurology, 5777 E. Mayo Blvd., Phoenix, AZ 85054, USA.
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Drazkowski
authors.affiliation: Mayo Clinic Arizona, Division of Psychology, 13400 E. Shea Blvd., Scottsdale, AZ 85259, USA. Electronic address: locke.dona@mayo.edu.
authors.forename: Dona E C
authors.initials: DE
authors.lastname: Locke
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000209:etiology* / Q000523:psychology*; D000368:Aged; D004827:Epilepsy / Q000150:complications* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D010556:Personality Tests; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012640:Seizures / Q000150:complications* / Q000523:psychology*; D012959:Socioeconomic Factors; D013001:Somatoform Disorders / Q000209:etiology* / Q000523:psychology*
keywords: Alexithymia; Epilepsy; Psychogenic seizures; Quality of life; Somatization