OBJECTIVE: To determine short-term outcome and its predictors in patients with psychogenic nonepileptic attacks (PNEA). METHODS: Retrospective cohort study of outcomes relating to attendance at follow-up, spells, use of emergency services, employment, and social security payments recorded at 6 and 12 months post diagnosis in 260 consecutive patients. RESULTS: A total of 187 patients (71.9%) attended at least 1 follow-up visit, and 105 patients (40.4%) attended 2. A total of 71/187 patients (38.0%) were spell-free at last follow-up. In contrast, 35/187 patients (18.7%) had marked increase in spell frequency postdiagnosis. Delay to diagnosis had no relationship to outcome. Patients with anxiety or depression were 2.32 times less likely to become spell-free (p = 0.012), and patients drawing social security payments at baseline were 2.34 times less likely to become spell-free (p = 0.014), than patients without those factors. Men were 2.46 times more likely to become spell-free than women (p = 0.016). While 93/187 patients (49.7%) were using emergency medical services at baseline, only 29/187 (15.5%) were using them at follow-up (p < 0.001). This was independent of whether or not the patient became spell-free. CONCLUSION: A substantial minority of our patients became spell-free with communication of the diagnosis the only intervention. Previous psychiatric diagnoses, social security payments, and gender were important predictors of outcome. Most patients stopped using emergency services, irrespective of whether or not spells continued. Outcomes other than spell frequency may be important in patients with psychogenic nonepileptic attacks.
OBJECTIVE: To determine short-term outcome and its predictors in patients with psychogenic nonepileptic attacks (PNEA). METHODS: Retrospective cohort study of outcomes relating to attendance at follow-up, spells, use of emergency services, employment, and social security payments recorded at 6 and 12 months post diagnosis in 260 consecutive patients. RESULTS: A total of 187 patients (71.9%) attended at least 1 follow-up visit, and 105 patients (40.4%) attended 2. A total of 71/187 patients (38.0%) were spell-free at last follow-up. In contrast, 35/187 patients (18.7%) had marked increase in spell frequency postdiagnosis. Delay to diagnosis had no relationship to outcome. Patients with anxiety or depression were 2.32 times less likely to become spell-free (p = 0.012), and patients drawing social security payments at baseline were 2.34 times less likely to become spell-free (p = 0.014), than patients without those factors. Men were 2.46 times more likely to become spell-free than women (p = 0.016). While 93/187 patients (49.7%) were using emergency medical services at baseline, only 29/187 (15.5%) were using them at follow-up (p < 0.001). This was independent of whether or not the patient became spell-free. CONCLUSION: A substantial minority of our patients became spell-free with communication of the diagnosis the only intervention. Previous psychiatric diagnoses, social security payments, and gender were important predictors of outcome. Most patients stopped using emergency services, irrespective of whether or not spells continued. Outcomes other than spell frequency may be important in patients with psychogenic nonepileptic attacks.
Authors: T A Saifee; P Kassavetis; I Pareés; M Kojovic; L Fisher; L Morton; J Foong; G Price; E M Joyce; M J Edwards Journal: J Neurol Date: 2012-05-15 Impact factor: 4.849
Authors: Jeannette M Gelauff; Yasmine E M Dreissen; Marina A J Tijssen; Jon Stone Journal: Curr Treat Options Neurol Date: 2014-04 Impact factor: 3.598
Authors: Laura H Goldstein; Emily J Robinson; Izabela Pilecka; Iain Perdue; Iris Mosweu; Julie Read; Harriet Jordan; Matthew Wilkinson; Gregg Rawlings; Sarah J Feehan; Hannah Callaghan; Elana Day; James Purnell; Maria Baldellou Lopez; Alice Brockington; Christine Burness; Norman A Poole; Carole Eastwood; Michele Moore; John Dc Mellers; Jon Stone; Alan Carson; Nick Medford; Markus Reuber; Paul McCrone; Joanna Murray; Mark P Richardson; Sabine Landau; Trudie Chalder Journal: Health Technol Assess Date: 2021-06 Impact factor: 4.014