Abstracts

Rationale: Studies have found a similar incidence of depression, anxiety, and reduced quality of life (QOL) in psychogenic nonepileptic seizure (PNES) and temporal lobe epilepsy (TLE) patients. Dissimulation and greater psychiatric symptom severity have been postulated to contribute to reduced QOL, neuropsychological impairments, and condition chronicity in PNES patients. Health related locus of control has not been well studied in PNES patients. Studies thus far have not evaluated group differences in effort, psychopathology, QOL, and health related locus of control in a single sample. Methods: Thirty-three female patients diagnosed with PNES and 55 TLE patients were assessed in the areas of suspect effort(Test of Memory and Malingering), mood (Beck Depression Inventory, Beck Anxiety Inventory, Minnesota Multiphasic Personality Inventory-2nd edition), health related locus of control (Multidimensional Health Locus of Control Form C) and QOL (Quality of Life in Epilepsy). Results: The PNES and TLE groups did not differ on age and education level. While years of seizure activity were significantly different between the groups, this variable did not correlate with the outcome measures and thus was not used as a covariate. A significant between group difference in suspect effort/motivation was not found; both groups performed within the Average range. In regard to mood, no significant between group difference in symptoms of depression and anxiety on face valid measures of mood was found; group means were elevated and fell within the moderate classification of symptomatology. A significant difference was found on several clinical scales of the MMPI-2, as the PNES group scored significantly higher on the hypochondriasis, hysteria, psychopathic deviate, paranoia, psychasthenia, and schizophrenia scales in comparison to the TLE group. The labels of these scales should not be literally interpreted; results will be explained in regard to mood and personality traits revealed by these scores. Beliefs in internal and external locus of control and the influence of physicians and chance on the patient’s seizure condition were commensurate between the PNES and TLE groups. However, a significant between group difference was found in regard to the influence others (non-physicians) had on their seizure condition, with the PNES group reporting a higher impact. Moreover, significant between group differences in both physical and emotional domains of QOL were found. The PNES group reported a negative impact in emotional roles, social support, physical functioning, pain and fatigue as compared to the TLE group. Conclusions: Results reveal between group similarities in levels of suspect effort/motivation and face valid symptoms of depression and anxiety. PNES patients endorsed an increase in psychological symptoms and declines in QOL in comparison to their TLE counterparts. Psychological results in conjunction with their health related beliefs can be utilized to implement appropriate medical interventions.