Report on a psychoeducational intervention for psychogenic non-epileptic seizures in Argentina

Purpose: To examine the effects of a three-session psychoeducational intervention on patients diagnosed with psychogenic non-epileptic seizures (PNES) in an Argentinian public hospital. It was hypothesized that patients would experience improvements in their understanding of PNES, illness perception and affective scores, but might not necessarily experience a significant change in post-traumatic and dissociative symptoms and in seizure frequency. Methods: This study included 12 patients (10 women, 2 men) who were invited to participate in a psychoeducational group after receiving a V-EEG confirmed diagnosis of PNES. The group consisted of 3 sessions lasting 2 h each. Pre and post measures included Psychoeducational Intervention Questionnaire, State-Trait Anxiety Inventory, Beck Depression Inventory-II, Brief Illness Perception Questionnaire, Posttraumatic Stress Disorder Diagnostic Scale 5, Dissociative Experiences Scale (DES-M). Results: This psychoeducational intervention produced results that were similar to interventions reported in US and European studies with regard to changes on psychological measures. Moreover, many patients also reported (on the final day of the intervention) a decrease in seizure frequency. All patients reported that participating in the intervention was a positive experience. Also, all but one patient referred that the participation in the group would have a positive impact on their quality of life. Conclusions: Psychoeducational interventions appear to have had positive results in Argentinian patients with PNES. This is initial step in the design of empirically based psychoeducational/supportive initiatives for patients in South America.Fil: Sarudiansky, Mercedes. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Centro Argentino de Etnología Americana; ArgentinaFil: Korman, Guido Pablo. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Centro Argentino de Etnología Americana; ArgentinaFil: Lanzillotti, Alejandra Inés. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Centro Argentino de Etnología Americana; ArgentinaFil: Areco Pico, María Marta. Centro Argentino de Etnología Americana; ArgentinaFil: Tenreyro, Cristina. Centro Argentino de Etnología Americana; ArgentinaFil: Valdez Paolasini, Maria Gabriela. Centro Argentino de Etnología Americana; ArgentinaFil: Wolfzun, Camila. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Centro Argentino de Etnología Americana; ArgentinaFil: Kochen, Sara Silvia. Universidad Nacional Arturo Jauretche. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos. Provincia de Buenos Aires. Ministerio de Salud. Hospital Alta Complejidad en Red El Cruce Dr. Néstor Carlos Kirchner Samic. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos; ArgentinaFil: D`alessio, Luciana. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Biología Celular y Neurociencia "Prof. Eduardo de Robertis". Universidad de Buenos Aires. Facultad de Medicina. Instituto de Biología Celular y Neurociencia; ArgentinaFil: Myers, Lorna. No especifíca

Quality of life in patients with epilepsy and psychogenic nonepileptic seizures: A systematic review

Se han revisado artículos que estudiaron la calidad de vida en las personas con crisis noepilépticas psicógenas (CNEP) y crisis epilépticas. Se siguió la guía PRISMA y, previo a labúsqueda, se realizó un protocolo publicado en PROSPERO. Se incluyeron estudios aleatorizadosy no aleatorizados, de tipo cuantitativo o mixtos, de corte transversal o longitudinal, escritos en lengua inglesa o española publicados hasta el año 2020, y cuyos participantes fueran mayores de 16 años. Luego de filtrar los resultados según los criterios de selección, se incluyeron 11 artículos y una tesis doctoral cuyos años de publicación datan de 1998 a 2020. En su mayoría, se informaba que laspersonas con CNEP tenían menor calidad de vida, asociadas a presencia de psicopatología, así como también a la toma de medicación antiepiléptica, factores sociodemográficos y relacionados con las crisis (frecuencia, severidad y duración de enfermedad), funcionamiento familiar, trauma y somatización.Psychogenic non epileptic seizures (PNES) are disruptive changes in behaviour, thought, or emotion that resemble an epileptic seizure, but without paroxysmal neuronal discharge detectable by electroencephalography (EEG), and are not caused by another medical condition. On the other hand, epileptic seizures (ES) are defined as clinical events that reflect the presence of hypersynchronous discharges of neurons located in the cerebral cortex, which have the particularity of starting and ending abruptly. The diagnosis of epilepsy is made when an epileptic seizure was experienced and there is a risk of having another. The objective of this paper is to present the results of a systematic review of articles that have studied quality of life in people with PNES and ES. This review has been performed following the PRISMA guide (Preferred Reporting Items for Systematic reviews and Meta-Analyses). Prior to the beginning of the search, a protocol was carried out and it is published for consultation in the International prospective register of systematic reviews (PROSPERO). The review includes randomized and non-randomized, quantitative or mixed, cross-sectional or longitudinal studies, published in English or Spanish until 2020. In addition, participants had to be over 16 years old. PNES diagnosis must have been confirmed by video-electroencephalography (VEEG) or a similar procedure-which is considered the gold standard for the diagnosis of PNES. In regards to research, PubMed, SciELO, Cochrane Library, Lilacs, Dialnet and Science Direct databases were reviewed. In addition, authors from epilepsy centers in Argentina were contacted in order to obtain local data and references of included studies were reviewed. The quality of the articles was evaluated using the guidelines of a tool created in a previous review by Brown and Reuber for PNES studies. It has been chosen to present the data in a narrative synthesis. As a result of the search, 678 references were obtained and after eliminating duplicates, 614 results were left. After filtering the results according to the selection criteria, 11 articles and a doctoral thesis were included. Their publication years date from 1998 to 2020. Most of them (10) were developed in the United States, one in Turkey and one in Argentina. English language was prevalent, being the doctoral thesis the only one written in spanish. Regarding the quality of the studies, most of them (9) were rated as medium quality; two of them as low quality and one as high quality. In regard to the scales employed to measure quality of life, the most widely used was Quality Of Life in Epilepsy (QOLIE), and QOLIE-31 was the most frequently used version of the instrument. It was found that people with PNES had a lower quality of life, mostly associated with the presence of psychopathology. Depression constitutes the most recurrent factor, followed by anxiety and personality traits. These results are consistent with previous research and gain importance when analysing the high rates of psychiatric comorbidity found in both groups of patients. To a lesser extent, other factors have shown a relationship with quality of life: taking anti-epileptic drugs, seizure-related factors (frequency, severity, duration of the disease), family functioning, demographic factors (sex), trauma and somatization. This study has potential limitations, including methodological problems of the articles included (non-randomized studies, dissimilar sample sizes between groups), quality of life scales dissimilarity among studies, and not having performed a meta-analysis, which would have provided more detailed information. Nevertheless, in conclusion, it could be stated that, in general, people with PNES have a lower quality of life than people with epileptic seizures.Fil: Wolfzun, Camila. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Psicología; Argentina. Centro Argentino de Etnología Americana; ArgentinaFil: Korman, Guido Pablo. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Psicología; Argentina. Centro Argentino de Etnología Americana; ArgentinaFil: Sarudiansky, Mercedes. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Psicología; Argentina. Centro Argentino de Etnología Americana; Argentin

Comorbid impulsivity after one year of epilepsy surgery

Background: Psychiatric comorbidities in patients with drug-resistant epilepsy (DRE) are frequentlyobserved before and after epilepsy surgery. Impulsivity, defined as behaviors that are poorly conceived, are also frequent among patients with epilepsy. The aim of this study was to determine the presence of comorbid impulsivity in patients with DRE after one year of epilepsy surgery.Methods: Patients who underwent epilepsy surgery for DRE and completed the postsurgical assessment protocol one year after surgery were included. All patients underwent a presurgical protocol comprising of neurological, psychiatric, neuropsychological, video-EEG and MRI assessments. The psychiatric evaluation was performed before and one year after surgery using SCID-I, SCID-II, GAF scale of DSM IV, and Beck Depression Inventory II. One year after surgery, Barratt Impulsiveness Scale 11, and Engel classification of seizures, were administered.Results: A total of 38 patients were included in this study, 21 women (55.3%) and 17 men (44.7%), mean age 36 years (SD = 9.4). Higher impulsivity was associated with a worse epilepsy seizure outcome (p < 0.05), one year after surgery. According to the multiple linear regression analysis, a worse epilepsy seizure outcome was associated with higher levels of nonplanning impulsivity (p < 0.05) (p < 0.05, b 0.5, r2 0.25). The GAF score was negatively associated with motor score (p < 0.05, b 0.584, r2 0.42) and with the total BIS-11 score (p < 0.05, b 0.557, r2 0.39).Conclusions: Impulsivity has been associated with a worse post-surgical seizure outcome. Larger studies about impulsivity might confirm these preliminary findings.Fil: Gonzalez Stivala, Ernesto. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Biología Celular y Neurociencia "Prof. Eduardo de Robertis". Universidad de Buenos Aires. Facultad de Medicina. Instituto de Biología Celular y Neurociencia; ArgentinaFil: Sarudiansky, Mercedes. Universidad de Buenos Aires; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Wolfzun, Camila. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires; ArgentinaFil: Giagante, Brenda. Universidad Nacional Arturo Jauretche. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos. Provincia de Buenos Aires. Ministerio de Salud. Hospital Alta Complejidad en Red El Cruce Dr. Néstor Carlos Kirchner Samic. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos; ArgentinaFil: Oddo, Silvia Andrea. Universidad Nacional Arturo Jauretche. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos. Provincia de Buenos Aires. Ministerio de Salud. Hospital Alta Complejidad en Red El Cruce Dr. Néstor Carlos Kirchner Samic. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos; ArgentinaFil: Seoane, Pablo. Universidad Nacional Arturo Jauretche. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos. Provincia de Buenos Aires. Ministerio de Salud. Hospital Alta Complejidad en Red El Cruce Dr. Néstor Carlos Kirchner Samic. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos; ArgentinaFil: Kochen, Sara Silvia. Universidad Nacional Arturo Jauretche. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos. Provincia de Buenos Aires. Ministerio de Salud. Hospital Alta Complejidad en Red El Cruce Dr. Néstor Carlos Kirchner Samic. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos; ArgentinaFil: D`alessio, Luciana. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Biología Celular y Neurociencia "Prof. Eduardo de Robertis". Universidad de Buenos Aires. Facultad de Medicina. Instituto de Biología Celular y Neurociencia; Argentin

Psychiatric disorders, depression and quality of life in patients with psychogenic non-epileptic seizures and drug resistant epilepsy living in Argentina

Objectives: Psychiatric disorders are frequently found in both patients with PNES and DRE, making the differential diagnosis even more complex. The aim of this study was to analyze and compare psychiatric aspects and the quality of life in patients with psychogenic non-epileptic seizures (PNES) and drug resistant epilepsy (DRE). Methods: Patients admitted to video-electroencephalograpy (VEEG) unit with confirmed PNES and DRE were included. Demographical characteristics, psychiatric diagnosis according to SCID I and II of DSM IV, pharmacological treatment, general functioning measured with GAF (Global assessment of functionality), quality of life (QoL) using QlesQSF (Quality of Life Enjoyment and Satisfaction Questionnaire Short Form) and depression severity using BDI II (Beck depression inventory), were compared between the groups. Non-parametric tests, chi square test, and logistic regression were used for statistical analysis. Results: 148 patients consecutively admitted to VEEG were included (DRE n = 97; PNES n = 51). Somatization disorder (RR: 13.02, 95% CI: 1.23–137.39, p = 0.03) and a history of trauma (RR: 8.66, 95% CI: 3.21–23.31, p = 0.001) were associated with PNES. The QlesQ score and the GAF score were lower with a higher prevalence of suicide attempts in the PNES group (p < 0.01). A negative correlation was observed between the severity of depression and the quality of life (DRE r = - 0.28, p = 0.013; PNES r = - 0.59, p = 0.001). Conclusions: Higher psychiatric comorbidity with poorer QoL were found in PNES patients compared to DRE. However, depression comorbidity negatively affected the QoL in both groups. Future studies based on illness perception will be orientated to complete this analysis.Fil: Scévola, Maria Laura. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Biología Celular y Neurociencia "Prof. Eduardo de Robertis". Universidad de Buenos Aires. Facultad de Medicina. Instituto de Biología Celular y Neurociencia; ArgentinaFil: Wolfzun, Camila. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires; Argentina. Centro Argentino de Etnología Americana; ArgentinaFil: Sarudiansky, Mercedes. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Centro Argentino de Etnología Americana; Argentina. Universidad de Buenos Aires; ArgentinaFil: Areco Pico, María Marta. Centro Argentino de Etnología Americana; Argentina. Universidad de Buenos Aires; ArgentinaFil: Ponieman, Micaela. Universidad de Buenos Aires; Argentina. Centro Argentino de Etnología Americana; ArgentinaFil: Gonzalez Stivala, Ernesto. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Biología Celular y Neurociencia "Prof. Eduardo de Robertis". Universidad de Buenos Aires. Facultad de Medicina. Instituto de Biología Celular y Neurociencia; Argentina. Universidad Nacional Arturo Jauretche. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos. Provincia de Buenos Aires. Ministerio de Salud. Hospital Alta Complejidad en Red El Cruce Dr. Néstor Carlos Kirchner Samic. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos; ArgentinaFil: Korman, Guido Pablo. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Psicología; ArgentinaFil: Kochen, Sara Silvia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Biología Celular y Neurociencia "Prof. Eduardo de Robertis". Universidad de Buenos Aires. Facultad de Medicina. Instituto de Biología Celular y Neurociencia; Argentina. Universidad Nacional Arturo Jauretche. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos. Provincia de Buenos Aires. Ministerio de Salud. Hospital Alta Complejidad en Red El Cruce Dr. Néstor Carlos Kirchner Samic. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos; ArgentinaFil: D`alessio, Luciana. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Biología Celular y Neurociencia "Prof. Eduardo de Robertis". Universidad de Buenos Aires. Facultad de Medicina. Instituto de Biología Celular y Neurociencia; Argentin