Abstracts

Measures of personality functioning are frequently included in the evaluation of patients suspected of having nonepileptic seizure (NES) disorder. Previous research has indicated that the Personality Assessment Inventory (PAI) provides moderate discrimination between patients with NES and those with epileptic seizures (ES)¹. In addition to personality assessment, evaluation of mood functioning using the Profile of Mood States - Depression scale (POMS-D) may serve to classify patients with seizure disorders who endorse depressive symptoms². The purpose of this study was to compare the discriminative properties of these measures in classifying patients with NES and ES., Patients were recruited upon admission to the video-EEG (v-EEG) monitoring unit, and completed the POMS and PAI prior to receiving their diagnosis. Twenty-eight patients (20 female, 8 male) with definitive diagnoses were included in the analysis. NES and ES patients were matched on age and education. v-EEG monitoring resulted in 20 diagnoses of ES and 8 diagnoses of NES., There was a borderline significant difference between groups on the POMS-D (p=.08), with the NES group endorsing more depression symptoms. On the PAI, the NES and ES groups differed significantly on the Somatic Complaints-Conversion (SOM-C) subscale, Antisocial Features-Antisocial Behaviors subscale, and Aggression-Verbal Aggression subscale (all p[apos]s [lt].05). The only clinically elevated scale was in the NES group on SOM-C (Mean T-score 72.7). In a discriminant function analysis (DFA) correcting for group size probabilities with v-EEG confirmed diagnosis as the dependent variable, the three PAI subscales provided an overall classification accuracy of 71.4%. In a separate DFA, the POMS-D provided an overall classification accuracy of 75%. When entered jointly, the PAI subscales and POMS provided an overall classification accuracy of 82.1%, Theories addressing the underlying etiology of NES have included both personality and mood factors. Psychological measures such as the PAI and POMS are routinely used in the work-up of both NES and ES patients when psychiatric features are suspected. These results suggest that used jointly, these measures can provide fairly accurate discrimination between these patient groups and may serve as useful screening instruments.
1. Wagner et al. Use of the Personality Assessment Inventory as an efficacious and cost-effective diagnostic tool for nonepileptic seizures. Epilepsy Behav 2005;7:301-304.
2. Griffith et al. Measuring depressive symptoms among treatment-resistant seizure disorder patients: POMS Depression scale as an alternative to the BDI-II. Epilepsy Behav 2005;7:266-272.,