Dissociative experiences in epilepsy: effects of epilepsy-related factors on pathological dissociation.
Psychogenic nonepileptic seizures (PNESs) in patients with epilepsy can be categorized as dissociative disorders. The prevalence of PNESs in patients with epilepsy appears to be much higher than that of dissociative experiences in nonclinical subjects. In order to clarify as to whether epilepsy-related factors were associated with pathological dissociation, we conducted a controlled study with 225 patients with epilepsy and 334 nonclinically matched individuals. All participants completed the Japanese version of the Dissociative Experiences Scale (DES). There was no significant difference in the DES score (DES-S) between the group with epilepsy and the control group. The group with epilepsy showed a significantly higher DES taxon (DES-T; a subset of DES-S and an index of pathological dissociation) than the control group. Thirty-one out of the 225 patients with epilepsy (13.8%) had PNESs. Because of its strong association with the DES-S and DES-T, PNESs can be regarded as a symptom of dissociation. With multiple regression analysis, the patients with a shorter duration of epilepsy, higher seizure frequency, or shorter period in education tend to suffer from pathological dissociation. These findings demonstrate that patients with epilepsy are more prone to experiencing pathological dissociation when having certain clinical factors.
Asai Hospital, Togane, Japan; Asahi General Hospital, Asahi, Japan.
Koichiro
K
Hara
National Center Hospital of Neurology and Psychiatry, Kodaira, Japan; Adachi Mental Clinic, Sapporo, Japan. Electronic address: adacchan@tky2.3web.ne.jp.
Naoto
N
Adachi
National Center Hospital of Neurology and Psychiatry, Kodaira, Japan; South London and Maudsley NHS Foundation Trust, London, UK.
Nozomi
N
Akanuma
National Center Hospital of Neurology and Psychiatry, Kodaira, Japan; Jozen Clinic, Sapporo, Japan.
Masumi
M
Ito
National Center Hospital of Neurology and Psychiatry, Kodaira, Japan.
Mitsutoshi
M
Okazaki
Sapporo Hanazono Hospital, Sapporo, Japan.
Ryoji
R
Matsubara
Adachi Mental Clinic, Sapporo, Japan.
Takuya
T
Adachi
Epilepsy Center, Osaka University, Osaka, Japan.
Ryouhei
R
Ishii
Aichi Medical University Hospital, Nagakute, Japan.
Kousuke
K
Kanemoto
Tokyo Medical and Dental University, Tokyo, Japan.
Masato
M
Matsuura
Tokyo Medical and Dental University, Tokyo, Japan.
Eriko
E
Hara
National Center Hospital of Neurology and Psychiatry, Kodaira, Japan; Musashino Kokubunji Clinic, Kokubunji, Japan.
Masaaki
M
Kato
National Center Hospital of Neurology and Psychiatry, Kodaira, Japan; Musashino Kokubunji Clinic, Kokubunji, Japan.
Teiichi
T
Onuma
D000328:Adult; D016022:Case-Control Studies; D004213:Dissociative Disorders / Q000453:epidemiology / Q000523:psychology*; D004828:Epilepsies, Partial / Q000453:epidemiology / Q000523:psychology*; D004827:Epilepsy / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012640:Seizures / Q000453:epidemiology / Q000523:psychology*; D013001:Somatoform Disorders / Q000453:epidemiology / Q000523:psychology; D055815:Young Adult
DES; Dissociation; Epilepsy; Psychogenic nonepileptic seizure; Seizure frequency