Abstracts

Psychiatric profiles of patients with PNES have been described. Limited comparison exists between historical self-reported psychiatric profiles with formal in-patient assessment. We compared patient self-reported psychiatric diagnosis with formal in-patient psychiatric evaluations preformed at the time of PNES diagnosis., Twenty six patients with confirmed PNES by inpatient VEEG done at a tertiary care epilepsy center were reviewed. The patients demographic information, history of headaches, suicide attempts, history of abuse, insomnia, chronic pain, self reported psychiatric problems, psychiatric medications, Anti-epileptic drugs, and psychiatric evaluation were collected and compared. Axis I diagnosis was made according to DSM-IV TR criteria. Statistical comparison was done looking at relative frequency of symptoms. The number of patients that self reported depression was compared to the number of patients to receive an Axis I diagnosis using the Mann-Whitney test. Data is reported as median (mean [plusmn] SD)., The patients were 42.3% males and had a median age of 43.5 years (40.4 [plusmn] 15.5). Only 19 of 26 patient received formal psychiatric evaluations while in hospital. Of the 19 patients, 89.5% had self reported mood disorder compared to 84.2% that received a formal inpatient Axis I diagnosis showing no statistical difference(p=0.783). 76.9% of all patients self reported a history of psychiatric symptoms. Vegetative symptoms such as headaches and insomnia were reported in 73% and 58% respectively. Seven patients (27%) reported suicide attempts in their lifetime. 18 of the 26 (69%) were already taking SSRIs at the time of evaluation, with 53.8% having been exposed to multiple psychiatric medications. Only 4% required altered medications during their hospitalization., We conclude that self-reported psychiatric diagnoses are concordant with psychiatric evaluation in patient PNES diagnoses. The majority of PNES patients were currently taking psychotropic medication at the time of in-patient diagnosis, and required no modification following formal psychiatric evaluation. The primary focus for ongoing psychiatric treatment in PNES patient should be provided on an outpatient basis.,