Young people diagnosed with psychogenic nonepileptic seizures have significantly more medical, neurologic, and psychiatric diagnoses; use more medications and medical services, and report having experienced significantly more adversity than did their siblings, according to a study of the biopsychosocial risk factor profile of pediatric sufferers.
Researchers conducted an exploratory study in 55 youth diagnosed with psychogenic nonepileptic seizures (PNES), and 35 sibling controls, finding those with PNES had a much higher incidence of anxiety, depression, posttraumatic stress disorder, and significantly higher somatization and anxiety sensitivity scores than did their non-PNES siblings.
The young people who had been diagnosed with PNES were aged 8-18 years and were living with the same parents as their siblings.
While cases and controls did not differ much in terms of daily hassles, those with PNES were more likely to report experiences of domestic or community violence, bullying, and serious medical problems, according to a paper published online (Epilepsia 2014 Sept. 19 [doi:10.1111/epi.12773]). Previous studies have shown that among young people with PNES, “the most common adversities are family discord, school problems, bullying, and interpersonal problems, but not physical or sexual abuse,” the authors wrote. “Since these studies were retrospective and did not include controls, it remains to be determine which of these adversities are specific risk factors for pediatric PNES,” wrote Dr. Sigita Plioplys, a professor of psychiatry and behavioral sciences at Northwestern University, and head of the Pediatric Neuropsychiatry Clinic at the Ann & Robert H. Lurie Children’s Hospital, both in Chicago, and her associates.
Most of the subjects in the current study were older adolescent girls (mean age was 14.8 years), and this limitation means the conclusions are not generalizable to either younger children or boys with PNES.
Still, the current findings “underscore the need for psychiatric treatment studies, exploring insight-oriented, family, trauma-based, and cognitive-behavioral therapies, as well as pharmacotherapeutic modalities to determine which approach should be utilized to address the illness’s complex biopsychosocial risk factor profile,” Dr. Plioplys and her associates wrote.
The study was supported by funding from the Epilepsy Foundation, the Feinberg School of Medicine at Northwestern, and UCLA Semel Institute for Neuroscience and Human Behavior. Three authors reported book royalties on related subjects, but no other conflicts of interest were declared.