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Demographic and clinical phenotypic differences between people with dissociative seizures and those with other psychiatric disorders.

Smakowski, A; Bird, JS; Pritchard, M; Mula, M (2021) Demographic and clinical phenotypic differences between people with dissociative seizures and those with other psychiatric disorders. BJPsych Open, 7 (2). e61. ISSN 2056-4724 https://doi.org/10.1192/bjo.2021.18
SGUL Authors: Mula, Marco

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Abstract

BACKGROUND: A large amount of literature surrounds the differences between dissociative neurological symptom disorder with non-epileptic seizures (DNSD-S) and epilepsy. AIMS: To explore the research gap on phenotypic differences between DNSD-S and other psychiatric disorders. METHOD: We conducted a case-control study of 1860 patients (620 patients with DNSD-S and 1240 controls with other psychiatric disorders) seen at the South London and Maudsley Hospital NHS Trust between 2007 and 2019. RESULTS: Compared with the controls, the patients with DNSD-S were more likely to be female (76 v. 47%, P < 0.001), of White ethnicity (77 v. 60%, P < 0.001), married (34 v. 14%, P < 0.001) and living in areas of lower socioeconomic status (-3.79, 95% CI -2.62 to -4.96, P < 0.001). Two peaks for age at diagnosis were observed for DNSD-S: the early 20s and late 40s. After 31 years of age, men's chance of being diagnosed with DNSD-S increased from 19 to 28% (P = 0.009). People with DNSD-S presented more commonly with a history of a neurological episodic or paroxysmal disorder (OR = 12, 95% CI 7.82-20.26), another dissociative disorder (OR = 10, 95% CI 1.64- 65.95) or unclassified signs or symptoms (OR = 4, 95% CI 2.61-6.43). Neither anxiety, depression nor other somatoform disorders predicted subsequent diagnosis of DNSD-S, and controls had a larger proportion of preceding psychiatric diagnoses than patients with DNSD-S (65 v. 49%, P < 0.001). CONCLUSIONS: This is the first study comparing demographic and phenotypic correlates of patients with DNSD-S against a large cohort of psychiatric patients. These data will inform development and drive service needs in psychiatry for people with DNSD-S.

Item Type: Article
Additional Information: This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work. Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists
Keywords: Non-epileptic seizures, dissociative disorders, neuropsychiatry, neuropsychology, psychopathology
SGUL Research Institute / Research Centre: Academic Structure > Institute of Medical & Biomedical Education (IMBE)
Academic Structure > Institute of Medical & Biomedical Education (IMBE) > Centre for Clinical Education (INMECE )
Journal or Publication Title: BJPsych Open
ISSN: 2056-4724
Language: eng
Dates:
DateEvent
24 February 2021Published
30 January 2021Accepted
Publisher License: Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0
PubMed ID: 33622429
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/113031
Publisher's version: https://doi.org/10.1192/bjo.2021.18

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