Abstracts

Rationale: The Patient-Reported Outcomes Measurement Information System (PROMIS) supported by the NIH is a validated and easy to use tool for self-reported health. We used a set of PROMIS measures in patients admitted to the Henry Ford Epilepsy Monitoring Unit (EMU) and diagnosed with either epilepsy or seizure like events with psychological basis (psychogenic non epileptic seizures; PNES) or both. We aimed to determine if there are any significant differences amongst the groups. This is a follow up study on our previous preliminary study presented at the AES meeting in 2011. Methods: A 46-item, five-domain measure set (PROMIS short forms) was used to assess general physical, social, and mental health (10 questions), pain behavior (7 questions), pain interference (6 questions), sleep disturbances (8 questions), depression (8 questions) and anxiety (7 questions). We included all EMU patients in the past 8 months except for those who declined participation, were younger than 18 or mentally challenged. The t-scores for all measures are scaled to a mean of 50 and standard deviation of 10. The EuroQoL (EQ-5D) index score (a disease non specific quality of life instrument) was also calculated. "Epilepsy", "epilepsy and non-epilepsy", and "non-epilepsy" groups were compared using ANOVA or a Kruskal-Wallis test. If a significant difference was found, post-hoc analyses were done. The post-hoc comparisons were either a two sample t-test, if ANOVA was used, or a Wilcoxon rank sum, if Kruskal-Wallis was performed. A Bonferroni adjustment was done for the post-hoc comparisons. Additional Chi-Square tests were done for race and gender comparison. Results: We included 69 patients (50 females; mean age 40.9 ± 12.5; 80% Caucasian). Thirty patients had epileptic seizures, 32 psychogenic non epileptic and 7 both. For pain interference, pain behavior, global physical health, and EQ-5D the "Epilepsy" patients were significantly different (p<0.05) than both the "Epilepsy and Non-Epilepsy" and "Non-Epilepsy" patients. We found no significant differences between the "Epilepsy and Non-Epilepsy" and "Non-Epilepsy" patients. Epilepsy patients had better pain interference (52.7 ± 9.9) and pain behavior (52.0 ± 10.2) t-scores (lower scores), global physical health (47.4 ± 7.0) and EQ-5D (0.69 ± 0.09) t-scores (higher scores) than non epilepsy (62.4 ± 10.9, 58.4 ± 9.4, 39.3 ± 10.0 and 0.60 ± 0.12, respectively). No differences were found in anxiety, depression and global mental health t-scores between the "Epilepsy" and the other two groups. Conclusions: We found no difference between "epilepsy: and "non epilepsy patients" in domains such anxiety, depression, sleep and global mental health. This finding is in agreement with a previous study from our group (Tojek et al, 2000) that showed that depression and anxiety were only marginally greater in non epilepsy when compared with epilepsy patients. In our studied groups patients with seizure like events with psychological basis have more impairment due to pain and worse global physical health and quality of life.