Psychosocial Factors and Antiepileptic Drug Use Related to Delayed Diagnosis of Refractory Psychogenic Nonepileptic Seizures

OBJECTIVE: We analyzed clinical and psychosocial factors in patients with refractory psychogenic nonepileptic seizures, seeking characteristics that could hasten diagnosis. BACKGROUND: Psychogenic nonepileptic seizures remain a diagnostic challenge. Prognosis is best if patients are treated within 2...

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Autores: Rodriguez-Urrutia, Amanda, Toledo, Manuel, Eiroá Orosa, Francisco José, Salas-Puig, Xavier, Santamarina, Estevo, Fidel-Kinori, Sara Guila, Parramon, Gemma, Casas, Miquel
Tipo de recurso: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2014
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/134072
Acceso en línea:https://hdl.handle.net/2445/134072
Access Level:acceso abierto
Palabra clave:Epilèpsia
Anticonvulsius
Convulsions
Epilepsy
Anticonvulsants
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spelling Psychosocial Factors and Antiepileptic Drug Use Related to Delayed Diagnosis of Refractory Psychogenic Nonepileptic SeizuresRodriguez-Urrutia, AmandaToledo, ManuelEiroá Orosa, Francisco JoséSalas-Puig, XavierSantamarina, EstevoFidel-Kinori, Sara GuilaParramon, GemmaCasas, MiquelEpilèpsiaAnticonvulsiusConvulsionsEpilepsyAnticonvulsantsConvulsionsOBJECTIVE: We analyzed clinical and psychosocial factors in patients with refractory psychogenic nonepileptic seizures, seeking characteristics that could hasten diagnosis. BACKGROUND: Psychogenic nonepileptic seizures remain a diagnostic challenge. Prognosis is best if patients are treated within 2 years of symptom onset. Psychosocial factors have been shown to provide important information for differential diagnosis. METHODS: Over a year and 1132 consecutive patients, our hospital's Epilepsy Unit suspected 93 patients of having psychogenic nonepileptic seizures and confirmed refractory psychogenic nonepileptic seizures in 67. We referred these patients to our psychiatric consultation unit for detailed diagnostic interviews, and 53 of the patients followed through. Two months after the psychiatric evaluation we gave them a psychiatric intervention, explaining the diagnosis and treating their comorbidities. We also tracked the patients' use of antiepileptic drugs for 3 months, from just before the psychiatric evaluation until a month after they started the intervention. RESULTS: Women, patients with an inadequate primary support group, and patients who had tried many antiepileptic drugs were most likely to have their diagnosis of psychogenic nonepileptic seizures delayed by >2 years after onset. A stepwise logistic regression showed that the 2 best predictors of late diagnosis were lack of availability of a primary support group and patients trying many antiepileptic drugs. CONCLUSIONS: Clinicians evaluating patients with questionable seizures should raise their suspicion of psychogenic nonepileptic seizures especially in female patients with an insufficient primary support group and a history of taking multiple antiepileptic drugs.Lippincott, Williams & Wilkins. Wolters Kluwer Health2014info:eu-repo/semantics/articleinfo:eu-repo/semantics/acceptedVersionapplication/pdfhttps://hdl.handle.net/2445/134072Articles publicats en revistes (Psicologia Clínica i Psicobiologia)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésVersió postprint del document publicat a: https://doi.org/10.1097/WNN.0000000000000045Cognitive And Behavioral Neurology, 2014, vol. 27, num. 4, p. 199-205https://doi.org/10.1097/WNN.0000000000000045(c) Lippincott, Williams & Wilkins. Wolters Kluwer Health, 2014info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1340722026-05-27T06:46:51Z
dc.title.none.fl_str_mv Psychosocial Factors and Antiepileptic Drug Use Related to Delayed Diagnosis of Refractory Psychogenic Nonepileptic Seizures
title Psychosocial Factors and Antiepileptic Drug Use Related to Delayed Diagnosis of Refractory Psychogenic Nonepileptic Seizures
spellingShingle Psychosocial Factors and Antiepileptic Drug Use Related to Delayed Diagnosis of Refractory Psychogenic Nonepileptic Seizures
Rodriguez-Urrutia, Amanda
Epilèpsia
Anticonvulsius
Convulsions
Epilepsy
Anticonvulsants
Convulsions
title_short Psychosocial Factors and Antiepileptic Drug Use Related to Delayed Diagnosis of Refractory Psychogenic Nonepileptic Seizures
title_full Psychosocial Factors and Antiepileptic Drug Use Related to Delayed Diagnosis of Refractory Psychogenic Nonepileptic Seizures
title_fullStr Psychosocial Factors and Antiepileptic Drug Use Related to Delayed Diagnosis of Refractory Psychogenic Nonepileptic Seizures
title_full_unstemmed Psychosocial Factors and Antiepileptic Drug Use Related to Delayed Diagnosis of Refractory Psychogenic Nonepileptic Seizures
title_sort Psychosocial Factors and Antiepileptic Drug Use Related to Delayed Diagnosis of Refractory Psychogenic Nonepileptic Seizures
dc.creator.none.fl_str_mv Rodriguez-Urrutia, Amanda
Toledo, Manuel
Eiroá Orosa, Francisco José
Salas-Puig, Xavier
Santamarina, Estevo
Fidel-Kinori, Sara Guila
Parramon, Gemma
Casas, Miquel
author Rodriguez-Urrutia, Amanda
author_facet Rodriguez-Urrutia, Amanda
Toledo, Manuel
Eiroá Orosa, Francisco José
Salas-Puig, Xavier
Santamarina, Estevo
Fidel-Kinori, Sara Guila
Parramon, Gemma
Casas, Miquel
author_role author
author2 Toledo, Manuel
Eiroá Orosa, Francisco José
Salas-Puig, Xavier
Santamarina, Estevo
Fidel-Kinori, Sara Guila
Parramon, Gemma
Casas, Miquel
author2_role author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Epilèpsia
Anticonvulsius
Convulsions
Epilepsy
Anticonvulsants
Convulsions
topic Epilèpsia
Anticonvulsius
Convulsions
Epilepsy
Anticonvulsants
Convulsions
description OBJECTIVE: We analyzed clinical and psychosocial factors in patients with refractory psychogenic nonepileptic seizures, seeking characteristics that could hasten diagnosis. BACKGROUND: Psychogenic nonepileptic seizures remain a diagnostic challenge. Prognosis is best if patients are treated within 2 years of symptom onset. Psychosocial factors have been shown to provide important information for differential diagnosis. METHODS: Over a year and 1132 consecutive patients, our hospital's Epilepsy Unit suspected 93 patients of having psychogenic nonepileptic seizures and confirmed refractory psychogenic nonepileptic seizures in 67. We referred these patients to our psychiatric consultation unit for detailed diagnostic interviews, and 53 of the patients followed through. Two months after the psychiatric evaluation we gave them a psychiatric intervention, explaining the diagnosis and treating their comorbidities. We also tracked the patients' use of antiepileptic drugs for 3 months, from just before the psychiatric evaluation until a month after they started the intervention. RESULTS: Women, patients with an inadequate primary support group, and patients who had tried many antiepileptic drugs were most likely to have their diagnosis of psychogenic nonepileptic seizures delayed by >2 years after onset. A stepwise logistic regression showed that the 2 best predictors of late diagnosis were lack of availability of a primary support group and patients trying many antiepileptic drugs. CONCLUSIONS: Clinicians evaluating patients with questionable seizures should raise their suspicion of psychogenic nonepileptic seizures especially in female patients with an insufficient primary support group and a history of taking multiple antiepileptic drugs.
publishDate 2014
dc.date.none.fl_str_mv 2014
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/acceptedVersion
format article
status_str acceptedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/134072
url https://hdl.handle.net/2445/134072
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Versió postprint del document publicat a: https://doi.org/10.1097/WNN.0000000000000045
Cognitive And Behavioral Neurology, 2014, vol. 27, num. 4, p. 199-205
https://doi.org/10.1097/WNN.0000000000000045
dc.rights.none.fl_str_mv (c) Lippincott, Williams & Wilkins. Wolters Kluwer Health, 2014
info:eu-repo/semantics/openAccess
rights_invalid_str_mv (c) Lippincott, Williams & Wilkins. Wolters Kluwer Health, 2014
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Lippincott, Williams & Wilkins. Wolters Kluwer Health
publisher.none.fl_str_mv Lippincott, Williams & Wilkins. Wolters Kluwer Health
dc.source.none.fl_str_mv Articles publicats en revistes (Psicologia Clínica i Psicobiologia)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,300719

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