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Seizure. 2015 Jul;29:4-10. doi: 10.1016/j.seizure.2015.03.007. Epub 2015 Mar 20.

Emotion processing and psychogenic non-epileptic seizures: A cross-sectional comparison of patients and healthy controls.

Author information

1
Academic Neurology Unit, University of Sheffield, Royal Hallamshire Hospital, Glossop Road, Sheffield, UK. Electronic address: bnovakova1@sheffield.ac.uk.
2
Department of Neurology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK. Electronic address: stephanie.howlett@sth.nhs.uk.
3
Bournemouth University Clinical Research Unit, Bournemouth University, Bournemouth, UK. Electronic address: rbaker@bournemouth.ac.uk.
4
Academic Neurology Unit, University of Sheffield, Royal Hallamshire Hospital, Glossop Road, Sheffield, UK; Department of Neurology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK. Electronic address: markus.reuber@sth.nhs.uk.

Abstract

PURPOSE:

This exploratory study aimed to examine emotion-processing styles in patients with psychogenic non-epileptic seizures (PNES), compared to healthy individuals, and to explore associations of emotion processing with other psychological measures and seizure frequency, using the new Emotional Processing Scale (EPS-25), which had not previously been used in this patient group.

METHODS:

Fifty consecutive patients with PNES referred for psychotherapy completed a set of self-report questionnaires, including the Emotional Processing Scale (EPS-25), Clinical Outcome in Routine Evaluation (CORE-10), Short Form-36 (SF-36), Patient Health Questionnaire (PHQ-15), and Brief Illness Perception Questionnaire (BIPQ). Responses on the EPS-25 were compared to data from 224 healthy controls.

RESULTS:

Patients with PNES had greater emotion processing deficits across all dimensions of the EPS-25 than healthy individuals (suppression/unprocessed emotion/unregulated emotion/avoidance/impoverished emotional experience). Impaired emotion processing was highly correlated with psychological distress, more frequent and severe somatic symptoms, and a more threatening understanding of the symptoms. Emotion processing problems were also associated with reduced health-related quality of life on the mental health (but not the physical health) component of the SF-36. The unregulated emotions sub-scale of the EPS was associated with lower seizure frequency.

CONCLUSION:

The results showed clear impairments of emotion processing in patients with PNES compared to healthy individuals, which were associated with greater psychological distress and reduced mental health functioning. These findings seem to support the face validity of the EPS-25 as a measure for PNES patients and its potential as a tool to assess the effectiveness of psychological interventions.

KEYWORDS:

Avoidance; Dissociative disorder; Emotion processing; Health-related quality of life; Non-epileptic seizures; Somatic symptoms

PMID:
26076837
DOI:
10.1016/j.seizure.2015.03.007
[Indexed for MEDLINE]
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