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Dissociative and associated psychopathological symptoms in patients with epilepsy, pseudoseizures, and both seizure
Christian Prueter1, Ulrich Schultz-Venrath, Wilhelm Rimpau
1Department of Psychiatry and Psychotherapy, University Hospital of the Technical University, Aachen, Germany. Christian.Prueter@post.rwth-aachen.de
Purpose:
A controversy currently exists regarding the significance of dissociation and conversion in the pathogenesis of pseudoepileptic seizures. After the abolition of the term "hysterical neurosis" from the current diagnostic systems, these seizures were diagnosed as either Dissociative Disorders (ICD-10) or in the DSM IV as Somatoform disorder, most often of conversion type. Recent studies of patients with Dissociative Disorders found that most patients also had conversion symptoms.
Methods:
In the present study, 60 patients of an outpatient clinic for epilepsy were assessed for the presence of dissociative symptoms and general psychopathologic symptoms by using the German version of the Dissociative Experience Scale (DES) and the Symptom Check List (SCL-90-R).
Results:
The patients with pseudoepileptic seizures showed a significantly higher incidence of dissociation (p < 0.0098) and general psychopathologic symptoms (p < 0.0083). Depression, anxiety, and obsession were dominating psychopathologic symptoms in all patients.
Conclusions:
The significantly higher incidence of dissociation in the patients with pseudoepileptic seizures suggests dissociation in the pathogenesis of these seizures.