Psychiatric comorbidity in veterans with psychogenic seizures

Epilepsy Behav. 2012 Nov;25(3):345-9. doi: 10.1016/j.yebeh.2012.07.013. Epub 2012 Oct 24.


Psychogenic non-epileptic seizures (PNES) are frequently encountered in epilepsy monitoring units (EMU) at Veterans Affairs Medical Centers (VAMCs) and cause significant long-term disability. An understanding of psychiatric factors associated with PNES could aid in earlier diagnosis and treatment. We studied 50 consecutive veterans diagnosed with PNES and 37 veterans diagnosed with epileptic seizures (ES), evaluated at a VAMC EMU. We reviewed all available mental health evaluations prior to EMU evaluation. Univariate comparisons included axis I diagnoses, axis II diagnoses, and psychiatric hospitalizations. Predictive models of seizure classification were evaluated by logistic regression. A diagnosis of post-traumatic stress disorder (PTSD) preceded the diagnosis of PNES in 58% of patients and the diagnosis of ES in 13.5% (p<0.001). On logistic regression, PTSD was the only significant psychiatric diagnosis (odds ratio 9.2). Major depression and alcohol abuse were common diagnoses but did not differentiate PNES and ES groups.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Comorbidity
  • Conversion Disorder / diagnosis
  • Conversion Disorder / epidemiology*
  • Conversion Disorder / psychology
  • Diagnosis, Differential
  • Disability Evaluation
  • Female
  • Hospitals, Veterans
  • Humans
  • Logistic Models
  • Longitudinal Studies
  • Male
  • Mental Disorders / diagnosis
  • Mental Disorders / epidemiology*
  • Middle Aged
  • Psychophysiologic Disorders / diagnosis
  • Psychophysiologic Disorders / epidemiology*
  • Psychophysiologic Disorders / psychology
  • Seizures / diagnosis
  • Seizures / epidemiology*
  • Seizures / psychology*
  • Veterans*
  • Young Adult