Suicidal Ideation and Traumatic Exposure Should Not Be Neglected in Epileptic Patients: A Multidimensional Comparison of the Psychiatric Profile of Patients Suffering From Epilepsy and Patients Suffering From Psychogenic Nonepileptic Seizures
Introduction: Patients with psychogenic nonepileptic seizures (PNESs) have often been exposed to traumatic events, which is a risk factor for suicidal behavior. This would suggest that the severity of suicidal ideation is greater in PNES than in patients suffering only from epileptic seizures (ESs)....
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Frontiers Media S.A.
2019-05-01
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Series: | Frontiers in Psychiatry |
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Online Access: | https://www.frontiersin.org/article/10.3389/fpsyt.2019.00303/full |
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Article |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Abel Guillen Jonathan Curot Jonathan Curot Jonathan Curot Philippe Jean Birmes Marie Denuelle Valérie Garès Simon Taib Simon Taib Luc Valton Luc Valton Luc Valton Antoine Yrondi Antoine Yrondi |
spellingShingle |
Abel Guillen Jonathan Curot Jonathan Curot Jonathan Curot Philippe Jean Birmes Marie Denuelle Valérie Garès Simon Taib Simon Taib Luc Valton Luc Valton Luc Valton Antoine Yrondi Antoine Yrondi Suicidal Ideation and Traumatic Exposure Should Not Be Neglected in Epileptic Patients: A Multidimensional Comparison of the Psychiatric Profile of Patients Suffering From Epilepsy and Patients Suffering From Psychogenic Nonepileptic Seizures Frontiers in Psychiatry PNES epilepsy suicidal behavior suicide trauma PTSD |
author_facet |
Abel Guillen Jonathan Curot Jonathan Curot Jonathan Curot Philippe Jean Birmes Marie Denuelle Valérie Garès Simon Taib Simon Taib Luc Valton Luc Valton Luc Valton Antoine Yrondi Antoine Yrondi |
author_sort |
Abel Guillen |
title |
Suicidal Ideation and Traumatic Exposure Should Not Be Neglected in Epileptic Patients: A Multidimensional Comparison of the Psychiatric Profile of Patients Suffering From Epilepsy and Patients Suffering From Psychogenic Nonepileptic Seizures |
title_short |
Suicidal Ideation and Traumatic Exposure Should Not Be Neglected in Epileptic Patients: A Multidimensional Comparison of the Psychiatric Profile of Patients Suffering From Epilepsy and Patients Suffering From Psychogenic Nonepileptic Seizures |
title_full |
Suicidal Ideation and Traumatic Exposure Should Not Be Neglected in Epileptic Patients: A Multidimensional Comparison of the Psychiatric Profile of Patients Suffering From Epilepsy and Patients Suffering From Psychogenic Nonepileptic Seizures |
title_fullStr |
Suicidal Ideation and Traumatic Exposure Should Not Be Neglected in Epileptic Patients: A Multidimensional Comparison of the Psychiatric Profile of Patients Suffering From Epilepsy and Patients Suffering From Psychogenic Nonepileptic Seizures |
title_full_unstemmed |
Suicidal Ideation and Traumatic Exposure Should Not Be Neglected in Epileptic Patients: A Multidimensional Comparison of the Psychiatric Profile of Patients Suffering From Epilepsy and Patients Suffering From Psychogenic Nonepileptic Seizures |
title_sort |
suicidal ideation and traumatic exposure should not be neglected in epileptic patients: a multidimensional comparison of the psychiatric profile of patients suffering from epilepsy and patients suffering from psychogenic nonepileptic seizures |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Psychiatry |
issn |
1664-0640 |
publishDate |
2019-05-01 |
description |
Introduction: Patients with psychogenic nonepileptic seizures (PNESs) have often been exposed to traumatic events, which is a risk factor for suicidal behavior. This would suggest that the severity of suicidal ideation is greater in PNES than in patients suffering only from epileptic seizures (ESs). However, these psychiatric symptoms may be underestimated in the ES population. The specific features or similarities between the psychiatric clinical profiles of these two groups should be elaborated to improve therapeutic management. Our study is the first to compare suicidal ideation, suicide risk, posttraumatic stress disorder (PTSD), and depression disorder simultaneously in both groups, in a tertiary care epilepsy center.Material and methods: We prospectively enrolled patients hospitalized for video-electroencephalography (EEG) monitoring to assess repeated seizures before an ES or a PNES diagnosis was made. During the psychiatric consultation that accompanied the video EEG, we rated the severity of suicidal ideation and depressive symptoms, suicidal risk, traumatic exposure history, and PTSD symptoms.Results: Eighteen subjects were enrolled and diagnosed with PNES, and 42, with ES. The PNES group reported more exposures to traumatic events and more intense PTSD symptoms (median: 17 vs. 27; p = 0.001). The severity of suicidal ideation did not differ significantly between the two groups.Conclusion: It is the severity of PTSD symptoms in PNES patients that differentiates them from ES patients, although exposure to traumatic events is also frequent in ES patients. We demonstrated that suicidal ideation and suicide risk are equally high in the ES and PNES groups. Therefore, both groups require extreme vigilance in terms of suicidal risk. |
topic |
PNES epilepsy suicidal behavior suicide trauma PTSD |
url |
https://www.frontiersin.org/article/10.3389/fpsyt.2019.00303/full |
work_keys_str_mv |
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doaj-139b0d99da3e432f9611627b96566ecf2020-11-25T02:18:04ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402019-05-011010.3389/fpsyt.2019.00303437211Suicidal Ideation and Traumatic Exposure Should Not Be Neglected in Epileptic Patients: A Multidimensional Comparison of the Psychiatric Profile of Patients Suffering From Epilepsy and Patients Suffering From Psychogenic Nonepileptic SeizuresAbel Guillen0Jonathan Curot1Jonathan Curot2Jonathan Curot3Philippe Jean Birmes4Marie Denuelle5Valérie Garès6Simon Taib7Simon Taib8Luc Valton9Luc Valton10Luc Valton11Antoine Yrondi12Antoine Yrondi13Explorations Neurophysiologiques (Neurophysiological Investigations), Hôpital Pierre Paul Riquet, CHU Purpan (Toulouse University Hospital), Toulouse, FranceExplorations Neurophysiologiques (Neurophysiological Investigations), Hôpital Pierre Paul Riquet, CHU Purpan (Toulouse University Hospital), Toulouse, FranceCentre de Recherche Cerveau et Cognition (Brain and Cognition Research Centre), University of Toulouse, Toulouse, FranceCentre National de la Recherche Scientifique CerCo (CerCo National Scientific Research Centre), Toulouse, FranceToulouse NeuroImaging Centre, University of Toulouse, Inserm, UPS, Toulouse, FranceExplorations Neurophysiologiques (Neurophysiological Investigations), Hôpital Pierre Paul Riquet, CHU Purpan (Toulouse University Hospital), Toulouse, FranceUniversity of Rennes, INSA, CNRS, IRMAR-UMR 6625, Rennes, FranceToulouse NeuroImaging Centre, University of Toulouse, Inserm, UPS, Toulouse, FranceService de Psychiatrie et Psychologie Médicale (Department of Psychiatry and Medical Psychology), CHU de Toulouse (Toulouse University Hospital), Toulouse, FranceExplorations Neurophysiologiques (Neurophysiological Investigations), Hôpital Pierre Paul Riquet, CHU Purpan (Toulouse University Hospital), Toulouse, FranceCentre de Recherche Cerveau et Cognition (Brain and Cognition Research Centre), University of Toulouse, Toulouse, FranceCentre National de la Recherche Scientifique CerCo (CerCo National Scientific Research Centre), Toulouse, FranceToulouse NeuroImaging Centre, University of Toulouse, Inserm, UPS, Toulouse, FranceService de Psychiatrie et Psychologie Médicale (Department of Psychiatry and Medical Psychology), CHU de Toulouse (Toulouse University Hospital), Toulouse, FranceIntroduction: Patients with psychogenic nonepileptic seizures (PNESs) have often been exposed to traumatic events, which is a risk factor for suicidal behavior. This would suggest that the severity of suicidal ideation is greater in PNES than in patients suffering only from epileptic seizures (ESs). However, these psychiatric symptoms may be underestimated in the ES population. The specific features or similarities between the psychiatric clinical profiles of these two groups should be elaborated to improve therapeutic management. Our study is the first to compare suicidal ideation, suicide risk, posttraumatic stress disorder (PTSD), and depression disorder simultaneously in both groups, in a tertiary care epilepsy center.Material and methods: We prospectively enrolled patients hospitalized for video-electroencephalography (EEG) monitoring to assess repeated seizures before an ES or a PNES diagnosis was made. During the psychiatric consultation that accompanied the video EEG, we rated the severity of suicidal ideation and depressive symptoms, suicidal risk, traumatic exposure history, and PTSD symptoms.Results: Eighteen subjects were enrolled and diagnosed with PNES, and 42, with ES. The PNES group reported more exposures to traumatic events and more intense PTSD symptoms (median: 17 vs. 27; p = 0.001). The severity of suicidal ideation did not differ significantly between the two groups.Conclusion: It is the severity of PTSD symptoms in PNES patients that differentiates them from ES patients, although exposure to traumatic events is also frequent in ES patients. We demonstrated that suicidal ideation and suicide risk are equally high in the ES and PNES groups. Therefore, both groups require extreme vigilance in terms of suicidal risk.https://www.frontiersin.org/article/10.3389/fpsyt.2019.00303/fullPNESepilepsysuicidal behaviorsuicidetraumaPTSD |