A comprehensive profile of clinical, psychiatric, and psychosocial characteristics of patients with psychogenic nonepileptic seizures

Purpose: To attain a comprehensive profile of clinical, psychiatric and psy chosocial characteristics of patients with psychogenic nonepileptic seizure s (NESs), and to assess the relation of these factors to NES outcome. Methods: We administered a telephone-based structured questionnaire to 56 p atients with NESs (16 male and 40 female patients; mean age, 35 years) at a mean follow-up time of 18 months after making the diagnosis of NES. Results: Mean age of NES onset was 28 years with a mean duration of 8 years . Episodes resolved in 29 (51.8%) cases, decreased in 24 (42.9%), persisted unchanged in two (3.6%), and increased in frequency in one (1.8%). Thirty (53.6%) patients, including 13 (44.8%) of patients whose NESs resolved, wer e rehospitalized for NESs or for other symptoms. Twenty-nine (51.8%) had si gnificant depressive symptoms, 22 (39.3%) had suicidal ideation, and 11 (19 .6%) attempted suicide [including 6 (21%) of the patients whose NESs resolv ed]. Believing the NES diagnosis was associated with resolution or improvem ent of NES frequency (p < 0.029), whereas anger in response to receiving th e diagnosis did not predict a poorer outcome. Patients' perceptions of havi ng good health (p < 0.02) and good occupational functioning (p < 0.04) were highly correlated with NES resolution. Only patients whose episodes resolv ed were employed at the time of follow-up. Conclusions: At a mean of 1.5 years, NES outcome was poor, with resolution in only half the group and with frequent rehospitalizations after NES diagn osis, even among patients whose NES resolved. Depressive symptoms, suicidal ideation, and suicide attempts were common. Believing the NES diagnosis an d patient perceptions of having good health and good occupational functioni ng correlated well with NES resolution.