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The effect of attachment style on long-term outcomes in psychogenic nonepileptic seizures: Results from a prospective

Antonia Villagrán1, Caroline Lund2, Roderick Duncan3

  • 1National Centre for Epilepsy, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

Epilepsy & Behavior : E&B
|August 29, 2022
PubMed

Insights

Attachment anxiety and insecure attachment styles are linked to persistent psychogenic nonepileptic seizures (PNES). Lower attachment anxiety and specific parenting experiences predict seizure freedom in PNES patients.

Area of Science:

  • Neurology
  • Psychiatry
  • Psychology

Background:

  • Psychogenic nonepileptic seizures (PNES) are associated with insecure and fearful attachment styles.
  • Understanding the long-term clinical outcomes in PNES requires investigation into attachment and parenting styles.

Purpose of the Study:

  • To investigate the associations between long-term clinical outcome in PNES and attachment and parenting styles.
  • To explore demographic, clinical, and neuropsychiatric factors influencing PNES prognosis.

Main Methods:

  • Prospective recruitment of 53 patients (≥16 years) with documented PNES.
  • Baseline assessment included clinical characteristics, attachment, parenting styles, trauma, dissociation, and quality of life.
  • Follow-up at a mean of 70.45 months via telephone to assess current medical status and interventions.

Main Results:

  • 39% of patients were seizure-free at follow-up.
  • Seizure freedom was associated with lower attachment anxiety, less controlling fathers, and more caring mothers at baseline.
  • Predictors of seizure freedom included male gender, younger age at PNES onset, and less attachment anxiety.

Conclusions:

  • The long-term prognosis for PNES in a tertiary epilepsy center cohort is generally poor.
  • Attachment anxiety is identified as a significant risk factor for persistent PNES.
  • Assessing attachment patterns in PNES patients may hold therapeutic relevance.
Abstract

Keywords:
Dissociative seizuresFunctional neurological disorderGender differencesLong-term prognosis

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