Table_1_Past Trauma Is Associated With a Higher Risk of Experiencing an Epileptic Seizure as Traumatic in Patients With Pharmacoresistant Focal Epilepsy.DOCX
Objective: The present study aimed to evaluate the prevalence of traumatic experienced seizures (TES) and of postepileptic seizure PTSD (PS-PTSD) in patients with pharmacoresistant focal epilepsy and to explore the determining factors of TES.
Methods: We conducted an observational study enrolling 107 adult refractory epilepsy patients. We used the DSM-5 criteria of traumatic events and PTSD to define TES and PS-PTSD. We assessed all traumatic life events unrelated to epilepsy, general and specific psychiatric comorbidities, and quality of life.
Results: Nearly half (n = 48) of the 107 participants reported at least one TES (44.85%). Among these, one-third (n = 16) developed PS-PTSD. The TES group was more likely to experience traumatic events unrelated to epilepsy (p < 0.001), to have generalized anxiety disorder (p = 0.019), and to have specific psychiatric comorbidities [e.g., interictal dysphoric disorder (p = 0.024) or anticipatory anxiety of seizures (p = 0.005)]. They reported a severe impact of epilepsy on their life (p = 0.01). The determining factors of TES according to the multifactorial model were the experience of trauma (p = 0.008), a history of at least one psychiatric disorder (p = 0.03), and a strong tendency toward dissociation (p = 0.03).
Significance: Epileptic seizures may be a traumatic experience in some patients who suffer from pharmacoresistant epilepsy and may be the source of the development of PS-PTSD. Previous trauma unrelated to epilepsy and psychiatric history are determining factors of TES. These clinical entities should be explored systematically.
History
References
- https://doi.org//10.1111/epi.13670
- https://doi.org//10.1016/j.ncl.2016.06.015
- https://doi.org//10.1016/S0074-7742%2808%2900020-2
- https://doi.org//10.3389/fnmol.2014.00008
- https://doi.org//10.3389/neuro.08.024.2009
- https://doi.org//10.1097/PSY.0000000000000463
- https://doi.org//10.1016/j.yebeh.2014.09.028
- https://doi.org//10.1111/j.1528-1167.2012.03566.x
- https://doi.org//10.1016/S1525-5050%2802%2900602-9
- https://doi.org//10.1111/epi.12070
- https://doi.org//10.3390/bs7010007
- https://doi.org//10.1371/journal.pone.0038915
- https://doi.org//10.1016/j.jstrokecerebrovasdis.2013.09.019
- https://doi.org//10.1080/13548500601162747
- https://doi.org//10.1097/01.chi.0000186400.67346.02
- https://doi.org//10.1007/s00127-006-0127-2
- https://doi.org//10.1007/s11126-012-9243-1
- https://doi.org//10.1016/j.yebeh.2017.08.043
- https://doi.org//10.1046/j.1600-0404.2003.00151.x
- https://doi.org//10.1016/j.neurol.2018.01.053
- https://doi.org//10.1371/journal.pone.0161645
- https://doi.org//10.1176/ajp.151.8.1132
- https://doi.org//10.1037/1040-3590.12.2.210
- https://doi.org//10.1016/0022-3999%2894%2990005-1
- https://doi.org//10.1016/j.yebeh.2014.12.011
- https://doi.org//10.1016/j.yebeh.2016.02.015
- https://doi.org//10.1016/j.yebeh.2004.08.003
- https://doi.org//10.1016/j.seizure.2016.12.007
- https://doi.org//10.1136/bmj.316.7139.1236
- https://doi.org//10.1111/opo.12131
- https://doi.org//10.1016/j.eplepsyres.2017.06.005
- https://doi.org//10.1016/j.yebeh.2015.07.019
- https://doi.org//10.1016/j.tins.2008.06.006
- https://doi.org//10.1111/epi.12377
- https://doi.org//10.1073/pnas.1115396109
- https://doi.org//10.1111/j.1528-1167.2008.01902.x
- https://doi.org//10.1016/j.seizure.2020.12.006
- https://doi.org//10.1212/01.WNL.0000113763.11862.26
- https://doi.org//10.1016/j.psychres.2013.07.041
- https://doi.org//10.1016/j.yebeh.2005.06.006
- https://doi.org//10.1177/0898264316673511
- https://doi.org//10.1212/WNL.0b013e3181f25b16
- https://doi.org//10.1016/j.yebeh.2016.03.020
CC BY 4.0