How can we identify psychiatric morbidity in patients with psychogenic nonepileptic seizures? - Centre de Recherche en Automatique de Nancy Accéder directement au contenu
Article Dans Une Revue Epilepsy & Behavior Année : 2012

How can we identify psychiatric morbidity in patients with psychogenic nonepileptic seizures?

Résumé

In an interesting article, Magaudda et al. [1] explain that patients with mixed psychogenic nonepileptic seizures (PNES) and epilepsy are heterogeneous and can be divided into three groups based on a hypothesis concerning the etiological mechanisms in play. Identifying homogenous subgroups of patients in the large, heterogenous group of people with PNES is important, as it could provide a better understanding of PNES and help us to develop more specific treatments. Numerous previous studies have attempted to categorize patients with PNES on the basis of video/EEG analysis and automatic clustering [2], trauma history and levels of dissociation [3], psychiatric comorbidity or learning disability [4], and gender [5]. One of the most important methodological requirements in psychiatric research--indeed in all medical research fields--is to produce valid, reproducible data. But unfortunately, psychiatric clinical examination has been shown to perform poorly in terms of sensitivity and validity for research purposes [6] and [7]. Hence the current international standard is to use validated questionnaires to identify and describe psychiatric morbidity in both DSM-IV axis I (depression, schizophrenia, etc.) and DSM-IV axis II (personality disorders) [8] and [9]. In the field of PNES, associated or not associated with epilepsy, we also emphasize the need for strong interdisciplinary collaboration between neurology and psychiatry for diagnostic assessment, care, and follow-up of patients. It is regrettable that Dr. Magaudda does not mention any psychiatric intervention in the process of diagnosis and treatment of their patients, and that the study did not use a standardized psychiatric evaluation. Accordingly, we believe that this study does not meet the methodological requirements to support the interesting starting hypothesis, and will be difficult to replicate. Additional studies on this topic should be underpinned by close neurological and psychiatric collaboration and the use of validated questionnaires.

Dates et versions

hal-00656406 , version 1 (04-01-2012)

Identifiants

Citer

Raymund Schwan, Coraline Hingray, Vincent Laprevote, Jean-Pierre Vignal, Louis Maillard. How can we identify psychiatric morbidity in patients with psychogenic nonepileptic seizures?. Epilepsy & Behavior, 2012, 23 (4), pp.507. ⟨10.1016/j.yebeh.2011.10.022⟩. ⟨hal-00656406⟩
104 Consultations
0 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More