Childhood trauma in patients with epileptic versus non-epileptic seizures

Abstract

ABSTRACTObjectiveChildhood trauma has been implicated as a risk factor for the aetiology of psychogenic non-epileptic seizures (PNES). Relatively little attention has been paid to whether profiles of specific trauma types differ between patients with epilepsy and PNES. Investigating childhood trauma profiles in these patient groups may identify psychological vulnerabilities the predispose to developing PNES, and aid early diagnoses, prevention, and treatment.MethodsData were collected from two cohorts (nRetrospective=203;nProspective=209) admitted to video-EEG monitoring units in Melbourne Australia. The Childhood Trauma Questionnaire domain score differences between patient groups were investigated using standardised effect sizes and general linear mixed-effects models (GLMMs). Receiver operating characteristic curves were used to investigate classification accuracy.ResultsIn the retrospective cohort, patients diagnosed with PNES reported greater childhood emotional abuse, emotional neglect, physical abuse, sexual abuse, and physical neglect relative to epilepsy patients. These differences were replicated in the prospective cohort, except for physical abuse. GLMMs revealed significant main effects for group in both cohorts, but no evidence for any group by domain interactions. Reported sexual abuse showed the best screening performance of PNES, although no psychometric scores were adequate as isolated measures.SignificancePatients with PNES report greater frequency of childhood trauma than patients with epilepsy. This effect appears to hold across all trauma types, with no strong evidence emerging for a particular trauma type that is more prevalent in PNES. From a practical perspective, inquiring regarding a history of sexual abuse shows the most promise as a screening measure.SummaryRelatively little attention has been paid to whether profiles of specific trauma types differ between patients with epilepsy and PNES.We collected self-reported childhood trauma information from two independent cohorts of patients undergoing VEMPatients with PNES report greater frequency of childhood trauma than patients with epilepsy.This effect appears to hold across all trauma types, with no strong evidence emerging for a particular trauma type that is more prevalent in PNES.Inquiring regarding a history of sexual abuse shows the most promise as a screening measure.