Abstracts

Rationale: The objective of the study is to compare the psychosocial profiles and demographics of patients with psychogenic nonepileptic seizures (PNES) with psychogenic movement disorders (PMD). Psychological dysfunction is present in both PNES and PMD patients. Though PNES and PMD are usually studied separately, our hypothesis is that the psychosocial profiles and demographics are similar despite different clinical presentations. Methods: PNES patients from the University of Maryland Epilepsy Center (n=33) and PMD patients from the Movement Disorders Center (n=104) completed the SF-12 Health Status Survey, the Brief Symptom Inventory-18 (BSI-18), the Lorig Self Efficacy Scale, and a demographic questionnaire. PNES and PMD data were compared with standard t-tests. Results: Both PNES and PMD groups scored low on SF-12 Physical Health (mean 37.5 and 34.8, p=0.38) and Mental Health (mean 44.4 and 43.4, p=0.70) quality of life. Both groups had high BSI somatization (63.6 and 63.1, p=0.78), depression (54.8 and 55.6, p=0.76), and anxiety (57.6 and 56.0, p=0.49) scores. Both PNES and PMD groups had similar Self Efficacy scores in subsets of their perception of their ability To Manage Disease (11.8 v. 11.5, p=0.55), Do Chores (6.3 v. 6.5, p=0.70), Do Social Activities (4.5 v. 4.1, p=0.16), Manage Symptoms (10.0 v. 9.4, p=0.25), and Exercise (6.6 v. 6.0, p=0.17). Both groups had similar rates of marriage (66.7% and 69.6%, p=0.83), employment (45.4% and 44.4%, p=1.00) and level of education (39.4% and 41.4%, p=1.00). Differences between the groups were that PNES patients were more likely to be female than PMD patients (87.9% vs. 67.0%, p<0.05) and PNES patients were more likely to report episodic symptoms than PMD patients (100% vs. 66.7%, p=0.0008). In addition, the mean age at symptom onset (38.0 v. 44.2, p<0.05) and diagnosis (41.2 v. 47.1, p<0.05) was younger in PNES patients than PMD patients. Conclusions: Patients with PNES and PMD have similarly low levels of quality of life, and high levels of somatization, depression, and anxiety. In addition, they have similar confidence in their ability to perform certain tasks or behaviors. There are differences in gender and age of onset and diagnosis in these groups. In addition, there is a difference in presentation of symptoms with PNES patients having more episodic symptoms. PNES and PMD patients are likely to represent the same patient population with regard to their psychosocial disorder. Their similarities in self-efficacy, which is a modifiable perception, may suggest that common treatment strategies and resources could be used for these patients. Collaborative efforts to investigate the management of PNES and PMD are warranted in the future.