S Pick1, J D C Mellers2, L H Goldstein1. 1. Department of Psychology,Institute of Psychiatry, Psychology & Neuroscience, King's College London,London,UK. 2. Neuropsychiatry Outpatients Department,Maudsley Hospital, South London and Maudsley NHS Foundation Trust,London,UK.
Abstract
BACKGROUND: This study aimed to extend the current understanding of dissociative symptoms experienced by patients with dissociative (psychogenic, non-epileptic) seizures (DS), including psychological and somatoform types of symptomatology. An additional aim was to assess possible relationships between dissociation, traumatic experiences, post-traumatic symptoms and seizure manifestations in this group. METHOD: A total of 40 patients with DS were compared with a healthy control group (n = 43), matched on relevant demographic characteristics. Participants completed several self-report questionnaires, including the Multiscale Dissociation Inventory (MDI), Somatoform Dissociation Questionnaire-20, Traumatic Experiences Checklist and the Post-Traumatic Diagnostic Scale. Measures of seizure symptoms and current emotional distress (Hospital Anxiety and Depression Scale) were also administered. RESULTS: The clinical group reported significantly more psychological and somatoform dissociative symptoms, trauma, perceived impact of trauma, and post-traumatic symptoms than controls. Some dissociative symptoms (i.e. MDI disengagement, MDI depersonalization, MDI derealization, MDI memory disturbance, and somatoform dissociation scores) were elevated even after controlling for emotional distress; MDI depersonalization scores correlated positively with trauma scores while seizure symptoms correlated with MDI depersonalization, derealization and identity dissociation scores. Exploratory analyses indicated that somatoform dissociation specifically mediated the relationship between reported sexual abuse and DS diagnosis, along with depressive symptoms. CONCLUSIONS: A range of psychological and somatoform dissociative symptoms, traumatic experiences and post-traumatic symptoms are elevated in patients with DS relative to healthy controls, and seem related to seizure manifestations. Further studies are needed to explore peri-ictal dissociative experiences in more detail.
BACKGROUND: This study aimed to extend the current understanding of dissociative symptoms experienced by patients with dissociative (psychogenic, non-epileptic) seizures (DS), including psychological and somatoform types of symptomatology. An additional aim was to assess possible relationships between dissociation, traumatic experiences, post-traumatic symptoms and seizure manifestations in this group. METHOD: A total of 40 patients with DS were compared with a healthy control group (n = 43), matched on relevant demographic characteristics. Participants completed several self-report questionnaires, including the Multiscale Dissociation Inventory (MDI), Somatoform Dissociation Questionnaire-20, Traumatic Experiences Checklist and the Post-Traumatic Diagnostic Scale. Measures of seizure symptoms and current emotional distress (Hospital Anxiety and Depression Scale) were also administered. RESULTS: The clinical group reported significantly more psychological and somatoform dissociative symptoms, trauma, perceived impact of trauma, and post-traumatic symptoms than controls. Some dissociative symptoms (i.e. MDI disengagement, MDI depersonalization, MDI derealization, MDI memory disturbance, and somatoform dissociation scores) were elevated even after controlling for emotional distress; MDI depersonalization scores correlated positively with trauma scores while seizure symptoms correlated with MDI depersonalization, derealization and identity dissociation scores. Exploratory analyses indicated that somatoform dissociation specifically mediated the relationship between reported sexual abuse and DS diagnosis, along with depressive symptoms. CONCLUSIONS: A range of psychological and somatoform dissociative symptoms, traumatic experiences and post-traumatic symptoms are elevated in patients with DS relative to healthy controls, and seem related to seizure manifestations. Further studies are needed to explore peri-ictal dissociative experiences in more detail.
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
Authors: David L Perez; Timothy R Nicholson; Susannah Pick; Laura H Goldstein Journal: J Neurol Neurosurg Psychiatry Date: 2018-11-19 Impact factor: 10.154
Authors: Susannah Pick; David G Anderson; Ali A Asadi-Pooya; Selma Aybek; Gaston Baslet; Bastiaan R Bloem; Abigail Bradley-Westguard; Richard J Brown; Alan J Carson; Trudie Chalder; Maria Damianova; Anthony S David; Mark J Edwards; Steven A Epstein; Alberto J Espay; Béatrice Garcin; Laura H Goldstein; Mark Hallett; Joseph Jankovic; Eileen M Joyce; Richard A Kanaan; Roxanne C Keynejad; Kasia Kozlowska; Kathrin LaFaver; W Curt LaFrance; Anthony E Lang; Alex Lehn; Sarah Lidstone; Carine W Maurer; Bridget Mildon; Francesca Morgante; Lorna Myers; Clare Nicholson; Glenn Nielsen; David L Perez; Stoyan Popkirov; Markus Reuber; Karen S Rommelfanger; Petra Schwingenshuh; Tereza Serranova; Paul Shotbolt; Glenn T Stebbins; Jon Stone; Marina Aj Tijssen; Michele Tinazzi; Timothy R Nicholson Journal: J Neurol Neurosurg Psychiatry Date: 2020-02-28 Impact factor: 10.154
Authors: Akihiro Koreki; Sarah N Garfkinel; Marco Mula; Niruj Agrawal; Sarah Cope; Talia Eilon; Cassandra Gould Van Praag; Hugo D Critchley; Mark Edwards; Mahinda Yogarajah Journal: Epilepsia Date: 2020-06-05 Impact factor: 6.740