Risk Factors Of Psychogenic Non-epileptic Seizures In Patients With Epilepsy

Objective:To explore risk factors of psychogenic non-epileptic seizures in patients with epilepsy.Method:This was a case-control study involving patients with epilepsy who were treated and followed up at the Epilepsy Clinic of First Hospital of Jilin University from January 2021 to December 2022.Patients with epilepsy who were detected psychogenic non-epileptic seizures by videoelectroencephalograph monitoring during this period were selected as the combined group;patients with epilepsy only matched in age and sex were selected as the epilepsy-only group.Differences in sociodemographic characteristics,clinical characteristics,GAD-7 and c-NDDI-E scales between the two groups of participants were compared by univariate analysis.Then we used binary logistic regression analysis to explore risk factors for the occurrence of additional psychogenic non-epileptic seizures in patients with epilepsy.Result:A total of 53 patients with epilepsy combined with psychogenic non-epileptic seizures and 53 age-and sex-matched epilepsy-only patients were selected,with 36 female patients(67.9%)in both groups;the mean age was(31.2±11.8)years in the combined group and(31.2±12.1)years in the epilepsy-only group,with no statistical difference(P=0.994).Sociodemographically,unemployment was significantly higher in the combined group than in the epilepsy-only group(24.5%vs.9.4%,P=0.038).In terms of clinical characteristics,the combined group had significantly higher seizure frequency(P=0.001),more emotional precipitants(P<0.001)and more aura before attacks(P=0.018)than the epilepsy-only group.In terms of psychological levels,the combined group had significantly higher GAD-7 scale scores(P=0.001)and c-NDDI-E scale scores(P=0.011)than the epilepsy-only group.Through binary logistic regression analysis,emotional precipitants(OR=4.628,95%CI:1.511-14.174,P=0.007),frequency of seizures greater than or equal to once per month(OR=3.597,95%CI:1.352-9.569,P=0.010)and anxiety(OR=1.184,95%CI:1.007-1.390,P=0.040)were independent risk factors of psychogenic non-epileptic seizures.Conclusion:(1)Patients with both epileptic and psychogenic non-epileptic seizures had more unemployment status,higher monthly seizure frequency and tended to have more often auras and emotional triggers before attacks than patients with epilepsy-only.Also they were more likely to experience anxiety and depression compared to patients with epilepsy-only.(2)Emotional precipitants,frequency of seizures greater than or equal to once per month,and high anxiety levels may be risk factors for the occurrence of additional psychogenic non-epileptic seizures in patients with epilepsy.