Citation

Guillen A, Curot J, Birmes PJ, Denuelle M, Garès V, Taib S, Valton L, Yrondi A. Front. Psychiatry 2019; 10(MAY).

Copyright

(Copyright © 2019, Frontiers Media)

DOI

10.3389/fpsyt.2019.00303

PMID

unavailable

Abstract

INTRODUCTION: Patients with psychogenic nonepileptic seizures (PNESs) have often been exposed to traumatic events, which is a risk factor for suicidal behavior. This would suggest that the severity of suicidal ideation is greater in PNES than in patients suffering only from epileptic seizures (ESs). However, these psychiatric symptoms may be underestimated in the ES population. The specific features or similarities between the psychiatric clinical profiles of these two groups should be elaborated to improve therapeutic management. Our study is the first to compare suicidal ideation, suicide risk, posttraumatic stress disorder (PTSD), and depression disorder simultaneously in both groups, in a tertiary care epilepsy center. Material and methods: We prospectively enrolled patients hospitalized for video-electroencephalography (EEG) monitoring to assess repeated seizures before an ES or a PNES diagnosis was made. During the psychiatric consultation that accompanied the video EEG, we rated the severity of suicidal ideation and depressive symptoms, suicidal risk, traumatic exposure history, and PTSD symptoms.

RESULTS: Eighteen subjects were enrolled and diagnosed with PNES, and 42, with ES. The PNES group reported more exposures to traumatic events and more intense PTSD symptoms (median: 17 vs. 27; p = 0.001). The severity of suicidal ideation did not differ significantly between the two groups.

CONCLUSION: It is the severity of PTSD symptoms in PNES patients that differentiates them from ES patients, although exposure to traumatic events is also frequent in ES patients. We demonstrated that suicidal ideation and suicide risk are equally high in the ES and PNES groups. Therefore, both groups require extreme vigilance in terms of suicidal risk. Copyright © 2019 Guillen, Curot, Birmes, Denuelle, Garès, Taib, Valton and Yrondi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

Language: en

Keywords

adult; Trauma; human; Suicide; female; male; Epilepsy; PTSD; suicidal ideation; depression; Suicidal behavior; disease severity; posttraumatic stress disorder; neuroimaging; epilepsy; controlled study; antidepressant agent; clinical article; nuclear magnetic resonance imaging; carbamazepine; benzodiazepine; valproic acid; high risk patient; prospective study; gabapentin; lamotrigine; phenobarbital; topiramate; vigabatrin; phenytoin; pregabalin; electroencephalogram; DSM-IV; oxcarbazepine; zonisamide; Beck Depression Inventory; disease duration; Article; personal experience; checklist; ethosuximide; eslicarbazepine; DSM-5; levetiracetam; Beck Scale for Suicide Ideation; tertiary care center; mental disease assessment; lacosamide; PNES; psychogenic nonepileptic seizure; perampanel; population exposure; Posttraumatic Stress disorder CheckList Specific