Abstracts

Rationale: For both patients with epilepsy (PWE) and psychogenic non-epileptic seizures (PNES) comorbid conditions such as depression and anxiety substantially affect their health, treatment, and quality of life (QOL). However, the comorbid conditions in PNES patients are usually under-estimated and not adequately addressed by epileptologists in many cases. Few studies have addressed the impact of psychiatric comorbidity and QOL in these two conditions. The goal of our study was to compare the QOL in PWE and PNES who were admitted to an epilepsy monitoring unit (EMU) and determine the impact of psychiatric comorbidity on QOL in these two populations. Methods: This was a prospective observational study, in which 200 patients enrolled over a 12-month period completed standard surveys while admitted to our level-4 epilepsy monitoring unit (EMU). The survey included Quality of life in epilepsy (QOLIE-31), Generalized Anxiety Disorder 7-item (GAD-7), Patient Health Questionnaire (PHQ-9) and Beck Depression Inventory-II (BDI-II).  Clinical information including age, gender, social history, seizure history, medication/treatment history and other information relevant to their diagnosis were extracted from the electronic chart.  Results: Of the 200 participants, who completed the study, 113 had a diagnosis of epilepsy and 36 had the diagnosis of PNES, while 51 patients were excluded due to either a non-diagnostic evaluation or a mixed disorder. Compared to PWE, PNES had older age of onset (31±17 vs 18±13, p< 0.01).  43% of PNES patients and 30% of PWE had seizures at least once a week (p= 0.02). 12% of PNES patients and 41% of PWE were on 3 or more anti-seizure medications (p< 0.01). 67% of PNES patients vs 72% of PWE do not drive and 53% of PNES patients vs 55% of PWE were not working (p>0.05). Compared to PWE, PNES reported higher anxiety and depression scores: PNES vs PWE, GAD-7 12±5 vs 9±7, PHQ-9 11±5 vs 8±6, BDI-II 19±11 vs 12±10, p Conclusions: Despite distinct clinical profiles in PWE and PNES, both groups reported at least mild symptoms of anxiety and depression, and these symptom ratings were strongly associated with QOL in both groups. Compared to PWE, PNES had higher anxiety and depression rating. Thus, addressing psychiatric comorbidity in both PWE and PNES could potentially improve their QOL. Routine screening for psychiatric comorbidities would be beneficial for identifying comorbid conditions in EMU patients to help early intervention Funding: None