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Abstract Details

Depression and Anxiety Precede the Onset of Spells in Patients with Psychogenic Nonepileptic Seizures
Epilepsy/Clinical Neurophysiology (EEG)
Epilepsy/Clinical Neurophysiology (EEG) Posters (7:00 AM-5:00 PM)
049
To prospectively compare the frequencies of depression and anxiety in patients diagnosed with new onset psychogenic nonepileptic seizures (PNES) versus two age and gender-matched control groups consisting of patients with new onset seizures as well as normal individuals.
It is well established that psychiatric comorbidities, especially depression and anxiety, are common in patients with PNES. However, most previous studies evaluated patients with a long duration of illness. Thus, it remains unclear whether the psychiatric symptoms predate or are a consequence of the repeated spells.
Consecutive patients, 16 years and older, enrolled in a large prospective study for suspected new onset seizures and with documented PNES were included. We compared the scores of validated versions of the Beck Depression Inventory (BDI) and the State Trait Anxiety Inventory (STAI) between the PNES, epilepsy, and normal control groups. 
The 33 patients with new onset PNES had significantly higher depression and anxiety scores compared to those with new onset seizures and to normal controls. Twenty patients (60.6%) in the PNES group were clinically depressed compared to 5 (15.2%) in the epilepsy group and 1 (3%) in the control group. In the PNES group, 42.4% had state anxiety compared to 18.2% and 6.1 % in the epilepsy and normal control groups, respectively. Similarly, 51.5% of patients in the PNES group had trait anxiety compared to 12.1% and 3% in the epilepsy and normal control groups, respectively.
Our results indicate that depression and anxiety precede the onset of PNES and are not a psychopathology that develops because of recurrent spells.  The fact that more than 50% of patients with new onset PNES had clinically significant trait anxiety suggests that individuals with chronic anxiety are more predisposed to develop PNES.  These findings underscore the importance of performing a comprehensive psychiatric evaluation of patients with new onset PNES.
Authors/Disclosures
Omar N. Nofal, MD (UT Southwestern)
PRESENTER 		Dr. Nofal has nothing to disclose.
No disclosure on file
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No disclosure on file