Abstracts

Rationale: Alexithymia is defined as an impaired ability to understand and communicate one’s emotions. Persons with psychogenic non-epileptic seizures have been reported to have higher rates of alexithymia when compared to patients with epilepsy. Alexithymia is often associated to problematic psychological and psychosocial factors and is a target in many psychotherapies. The purpose of this study is to investigate whether alexithymia correlates with different features associated to quality of life (seizure worry, cognitive effects, etc.) and depression.

Methods: This is a retrospective study of 246 patients diagnosed with PNES (2009-2021). All patients were administered the Toronto Alexithymia Scale-20 (TAS) and the Quality of Life in Epilepsy-31 (QOLIE-31), and a small subset of these subjects (N = 55) were administered the Center for Epidemiological Studies-depression (CES-D). Subjects were split into two groups: those that scored a 61 or above (N1 = 92) and those that scored a 60 or below (N2 = 154) on the TAS.

Results: We found that the group with alexithymia (M1 = 13.45) had achieved less education than those without (M2 = 14.41) t(-0.97), p = .166. In addition, patients with alexithymia reported a significantly worse total QOLIE-31 (M1 = 32.54, SD = 160.45) than those without (M2 = 39.19, SD = 105.16) t(-4.50075), p < .00001. Furthermore, the alexithymia group reported significantly worse scores on all QOLIE sub measures, including seizure worry (t = -4.39169, p < .00001), social functioning (t = -2.37426, p = .009), emotional functioning (t = -3.07046, p = .001), and cognition (t = -4.74819, p < .00001). Among the subjects given the CES-D there was also a significant difference between those with alexithymia (N1 = 23, M1 = 31.42, SD = 170.43) and those without (N2 = 33, M2 = 21.7, SD = 139.91) t(2.93226), p = .002.

Conclusions: This study examined a sizable sample and replicated results regarding alexithymia prevalence (37%) and associations to psychological difficulties. Our findings suggest that overall, patients with PNES and alexithymia report a significantly poorer quality of life and endorse higher depressive symptoms. As for quality of life, this is not limited to any particular area but rather appears to affect cognitive, social, and emotional functioning (in the QOLIE and CES=D) as well as concerns regarding seizure occurrence. This data supports that PNES patients with alexithymia appear overall much more impaired than others who have PNES without alexithymia. Interesting future directions might include a more thorough examination of demographic and clinical data in this patient subgroup. Also, future treatment outcome studies might assess for alexithymia to observe if patients with this feature fare differently than those without.

Funding: Please list any funding that was received in support of this abstract.: None.