Psychiatric and neurologic predictors of psychogenic pseudoseizure outcome

Andres M Kanner, J. Parra, M. Frey, G. Stebbins, S. Pierre-Louis, J. Iriarte

Research output: Contribution to journalArticle

143 Citations (Scopus)

Abstract

Objective: To investigate the patterns of occurrence of psychogenic pseudoseizures (PPS) of 45 consecutive patients during a 6-month period after diagnosis, and to determine whether psychiatric and neurologic variables identified previously in PPS patient series can predict their recurrence after diagnosis, and whether any of these variables are associated with a particular outcome pattern. Method: Postdiagnosis PPS recurrence was assessed twice: during the first month and during a period ranging from the second to the sixth month. Outcome was categorized as follows: class I, complete cessation of PPS; class II, PPS only during one of the two observation periods; and class III, persistent PPS during the two observation periods. The authors used a logistic regression model to identify predictors of PPS recurrence (versus no PPS) among four neurologic and nine psychiatric variables, and compared their frequency among the three outcome classes. Results: Class I, n = 13 (29%); class II, n = 12 (27%); and class III, n = 20 (44%). The presence of an abnormal MR image predicted PPS recurrence during the second observation period with a 75% accuracy. The presence of all nine psychiatric variables predicted PPS recurrence during both the first and second observation periods with a 93% and an 89% accuracy respectively. Patients with a class III outcome had a markedly higher frequency of recurrent major depression, dissociative and personality disorders, and a history of chronic abuse. Patients with a class II outcome displayed a notably higher frequency of denial of stressors and psychosocial problems, refusal of treatment recommendations, and new somatic symptoms after disclosure of diagnosis. Conversely, one episode of major depression was the one common diagnosis in patients with a class I outcome. Conclusions: PPS outcome after disclosure of diagnosis can be predicted by the presence of certain psychiatric characteristics. More than one psychopathogenic mechanism appears to operate in PPS.

Original languageEnglish (US)
Pages (from-to)933-938
Number of pages6
JournalNeurology
Volume53
Issue number5
StatePublished - Sep 22 1999
Externally publishedYes

Fingerprint

Nervous System
Psychiatry
Recurrence
Observation
Disclosure
Treatment Refusal
Logistic Models
Dissociative Disorders
Depression
Personality Disorders

Keywords

  • Intractable epilepsy
  • Pseudoseizure outcome
  • Psychogenic pseudoseizures
  • Sexual abuse

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Kanner, A. M., Parra, J., Frey, M., Stebbins, G., Pierre-Louis, S., & Iriarte, J. (1999). Psychiatric and neurologic predictors of psychogenic pseudoseizure outcome. Neurology, 53(5), 933-938.

Psychiatric and neurologic predictors of psychogenic pseudoseizure outcome. / Kanner, Andres M; Parra, J.; Frey, M.; Stebbins, G.; Pierre-Louis, S.; Iriarte, J.

In: Neurology, Vol. 53, No. 5, 22.09.1999, p. 933-938.

Research output: Contribution to journalArticle

Kanner, AM, Parra, J, Frey, M, Stebbins, G, Pierre-Louis, S & Iriarte, J 1999, 'Psychiatric and neurologic predictors of psychogenic pseudoseizure outcome', Neurology, vol. 53, no. 5, pp. 933-938.
Kanner AM, Parra J, Frey M, Stebbins G, Pierre-Louis S, Iriarte J. Psychiatric and neurologic predictors of psychogenic pseudoseizure outcome. Neurology. 1999 Sep 22;53(5):933-938.
Kanner, Andres M ; Parra, J. ; Frey, M. ; Stebbins, G. ; Pierre-Louis, S. ; Iriarte, J. / Psychiatric and neurologic predictors of psychogenic pseudoseizure outcome. In: Neurology. 1999 ; Vol. 53, No. 5. pp. 933-938.
@article{33a316a35abb4a0996b3d081e24c81ff,
title = "Psychiatric and neurologic predictors of psychogenic pseudoseizure outcome",
abstract = "Objective: To investigate the patterns of occurrence of psychogenic pseudoseizures (PPS) of 45 consecutive patients during a 6-month period after diagnosis, and to determine whether psychiatric and neurologic variables identified previously in PPS patient series can predict their recurrence after diagnosis, and whether any of these variables are associated with a particular outcome pattern. Method: Postdiagnosis PPS recurrence was assessed twice: during the first month and during a period ranging from the second to the sixth month. Outcome was categorized as follows: class I, complete cessation of PPS; class II, PPS only during one of the two observation periods; and class III, persistent PPS during the two observation periods. The authors used a logistic regression model to identify predictors of PPS recurrence (versus no PPS) among four neurologic and nine psychiatric variables, and compared their frequency among the three outcome classes. Results: Class I, n = 13 (29{\%}); class II, n = 12 (27{\%}); and class III, n = 20 (44{\%}). The presence of an abnormal MR image predicted PPS recurrence during the second observation period with a 75{\%} accuracy. The presence of all nine psychiatric variables predicted PPS recurrence during both the first and second observation periods with a 93{\%} and an 89{\%} accuracy respectively. Patients with a class III outcome had a markedly higher frequency of recurrent major depression, dissociative and personality disorders, and a history of chronic abuse. Patients with a class II outcome displayed a notably higher frequency of denial of stressors and psychosocial problems, refusal of treatment recommendations, and new somatic symptoms after disclosure of diagnosis. Conversely, one episode of major depression was the one common diagnosis in patients with a class I outcome. Conclusions: PPS outcome after disclosure of diagnosis can be predicted by the presence of certain psychiatric characteristics. More than one psychopathogenic mechanism appears to operate in PPS.",
keywords = "Intractable epilepsy, Pseudoseizure outcome, Psychogenic pseudoseizures, Sexual abuse",
author = "Kanner, {Andres M} and J. Parra and M. Frey and G. Stebbins and S. Pierre-Louis and J. Iriarte",
year = "1999",
month = "9",
day = "22",
language = "English (US)",
volume = "53",
pages = "933--938",
journal = "Neurology",
issn = "0028-3878",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Psychiatric and neurologic predictors of psychogenic pseudoseizure outcome

AU - Kanner, Andres M

AU - Parra, J.

AU - Frey, M.

AU - Stebbins, G.

AU - Pierre-Louis, S.

AU - Iriarte, J.

PY - 1999/9/22

Y1 - 1999/9/22

N2 - Objective: To investigate the patterns of occurrence of psychogenic pseudoseizures (PPS) of 45 consecutive patients during a 6-month period after diagnosis, and to determine whether psychiatric and neurologic variables identified previously in PPS patient series can predict their recurrence after diagnosis, and whether any of these variables are associated with a particular outcome pattern. Method: Postdiagnosis PPS recurrence was assessed twice: during the first month and during a period ranging from the second to the sixth month. Outcome was categorized as follows: class I, complete cessation of PPS; class II, PPS only during one of the two observation periods; and class III, persistent PPS during the two observation periods. The authors used a logistic regression model to identify predictors of PPS recurrence (versus no PPS) among four neurologic and nine psychiatric variables, and compared their frequency among the three outcome classes. Results: Class I, n = 13 (29%); class II, n = 12 (27%); and class III, n = 20 (44%). The presence of an abnormal MR image predicted PPS recurrence during the second observation period with a 75% accuracy. The presence of all nine psychiatric variables predicted PPS recurrence during both the first and second observation periods with a 93% and an 89% accuracy respectively. Patients with a class III outcome had a markedly higher frequency of recurrent major depression, dissociative and personality disorders, and a history of chronic abuse. Patients with a class II outcome displayed a notably higher frequency of denial of stressors and psychosocial problems, refusal of treatment recommendations, and new somatic symptoms after disclosure of diagnosis. Conversely, one episode of major depression was the one common diagnosis in patients with a class I outcome. Conclusions: PPS outcome after disclosure of diagnosis can be predicted by the presence of certain psychiatric characteristics. More than one psychopathogenic mechanism appears to operate in PPS.

AB - Objective: To investigate the patterns of occurrence of psychogenic pseudoseizures (PPS) of 45 consecutive patients during a 6-month period after diagnosis, and to determine whether psychiatric and neurologic variables identified previously in PPS patient series can predict their recurrence after diagnosis, and whether any of these variables are associated with a particular outcome pattern. Method: Postdiagnosis PPS recurrence was assessed twice: during the first month and during a period ranging from the second to the sixth month. Outcome was categorized as follows: class I, complete cessation of PPS; class II, PPS only during one of the two observation periods; and class III, persistent PPS during the two observation periods. The authors used a logistic regression model to identify predictors of PPS recurrence (versus no PPS) among four neurologic and nine psychiatric variables, and compared their frequency among the three outcome classes. Results: Class I, n = 13 (29%); class II, n = 12 (27%); and class III, n = 20 (44%). The presence of an abnormal MR image predicted PPS recurrence during the second observation period with a 75% accuracy. The presence of all nine psychiatric variables predicted PPS recurrence during both the first and second observation periods with a 93% and an 89% accuracy respectively. Patients with a class III outcome had a markedly higher frequency of recurrent major depression, dissociative and personality disorders, and a history of chronic abuse. Patients with a class II outcome displayed a notably higher frequency of denial of stressors and psychosocial problems, refusal of treatment recommendations, and new somatic symptoms after disclosure of diagnosis. Conversely, one episode of major depression was the one common diagnosis in patients with a class I outcome. Conclusions: PPS outcome after disclosure of diagnosis can be predicted by the presence of certain psychiatric characteristics. More than one psychopathogenic mechanism appears to operate in PPS.

KW - Intractable epilepsy

KW - Pseudoseizure outcome

KW - Psychogenic pseudoseizures

KW - Sexual abuse

UR - http://www.scopus.com/inward/record.url?scp=0033595586&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033595586&partnerID=8YFLogxK

M3 - Article

VL - 53

SP - 933

EP - 938

JO - Neurology

JF - Neurology

SN - 0028-3878

IS - 5

ER -