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Emotional regulation profile of patients with psychogenic non-epileptic seizures (PNES)

Publication at Faculty of Physical Education and Sport, First Faculty of Medicine, Third Faculty of Medicine, Faculty of Arts |
2018

Abstract

Introduction: The term psychogenic non-epileptic seizures (PNES) refers to a conversion disorder (300.11) imitating epileptic seizures that are psychological etiology (DSM-5). Neuropsychological assessment including personality profile and mood status is an integral part of diagnosis and treatment of PNES.

Aims: We aimed to identify areas in which patients with PNES are especially impaired. These findings may be applied in subsequent psychotherapy.

Materials and Methods: 13 patients (F:M 12:1; mean age 33 years, disease duration  2 years) were assessed during their stay at the Center for Epilepsy, Na Homolce Hospital, Prague. PNES diagnosis was based on normal EEG findings, habitual seizure capture, suggestive seizure provocation, and patients' history.

We focused on the presence of maladaptation emotional regulation using Czech research version of self-report questionnaires Affective Style Questionnaire (ASQ) and Difficulty in Emotion Regulation Scale (DERS) in this study. Results: Compared to the norms patients with PNES had greater emotion regulation impairments across all dimensions of the DERS (Nonacceptance = 16.92 (M 9.66 SD 4.46), Goals = 16.15 (M 13.50 SD 4.80), Impulse control = 14.92 (M 11.27 SD 4.72), Awareness = 16.62 (M 14.32 SD 5.12), Strategies = 20.62 (M 16.01 SD 6.67), Clarity = 11.46 (M 10.53 SD 3.92).

Similar results were found in ASQ questionnaire (Concealing = 24.23 (M 23.94 SD 6.94), Tolerating = 14.62 (M 15.23 SD 3.42), Adjusting =19.00 (M 20.36 SD 5.05). Conclusion: Although our sample size was small, the results showed clear impairments of emotion processing in patients with PNES, which were associated with greater psychological distress and reduced mental health functioning.

These findings can help to improve psychological intervention of patients with PNES.