Abstracts

Rationale: Approximately 20-40% of patients who are referred to epilepsy centers have Non-epileptic seizures (NES) with coexisting psychiatric problems including complaints of depression, accompanied by report of sensory and motor deficits. NES has been extensively examined in the female population. However, more recent literature has suggested a higher prevalence of males in those with late-onset NES. The Personality Assessment Inventory (PAI), a well-developed self-administrated objective measure of adult personality, is frequently administered in the epilepsy population. The PAI Somatic Complaints (SOM) clinical scale and subscales are often elevated in those with NES. The Conversion Disorder subscale of SOM, which highlights symptoms associated with sensory and motor dysfunction, has been significantly elevated in NES but not ES groups. Still, most recent literature has not reviewed the PAI within the NES male population specifically. The current study compared NES males (NES-M) and NES females (NES-F) as well as NES-M and males with epileptic seizures (ES-M).Methods: In this retrospective study, the patient sample was taken from individuals who had been evaluated on an inpatient epilepsy-monitoring unit within the past two years. Continuous video-EEG monitoring (confirming NES or ES), neuropsychological testing, and the PAI were collected. Analysis of the PAI included clinical and subscales examining somatic complaints, depression, and antisocial features. The first analysis (1) was 22 NES-M vs.27 NES-F. The second analysis (2) was the NES-M vs. 28 ES-M.Results: (1) NES-M vs. NES-F did not differ on age, education, IQ, or memory scores. Both NES-M and NES-F had elevated PAI SOM clinical scale and subscales. Group differences were evidenced on the following PAI indices: (DEP-P) Physiological Depression, (ANT) Antisocial Features, and (ANT-E) Egocentricity. Also, the (ANT-A) Antisocial Behaviors subscale approached significance. (2) NES-M vs. ES-M did not differ on FSIQ but there was an age difference, average age was 44.0 (± 15.5) for NES-M and 35.4 (± 11.6) for ES-M. Statistically significant group difference between the NES-M and ES-M patients was evidenced on the PAI (SOM-C) Conversion subscale, (SOM-S) Somatization subscale, and (ANT-A) Antisocial Behaviors subscale. Conclusions: NES-M exhibited significantly more antisocial features, including egocentricity, compared to NES-F. However, NES-F endorsed physiological symptoms of depression at a significantly higher rate then NES-M. Both groups had moderately to clinically elevated scores on the SOM clinical scale and subscales, and NES-M had elevated conversion and somatization type symptoms at significantly higher rates than ES-M, consistent with previous NES studies. Though NES-M endorsed higher rates of antisocial behaviors compared to the NES-F group, the ES-M endorsed antisocial behaviors at higher rates than NES-M. Results revealed that the PAI can clarify aspects of the psychopathological underpinnings of male NES patients, which may be beneficial in the establishment of effective psychotherapeutic treatment.