Demographic and Seizure Variables, But Not Hypnotizability or Dissociation, Differentiated Psychogenic from Organic Seizures

Early detection and differential diagnosis of psychogenic non-epileptic seizures (PNES) and epileptic seizures (ES) is a major clinical issue in comprehensive epilepsy centers. Using blind conditions with patients with PNES (N = 10) and ES (N = 31) before diagnosis, we tested the hypotheses that individuals with PNES would exhibit significantly greater dissociativity, hypnotizability, absorption, and history of early abuse than ES patients. Although PNES patients tended to show greater dissociative phenomena, only the last of our hypotheses was fully supported. Although absorption did not discriminate between the two diagnostic groups, it was significantly higher among those reporting early abuse. A logistic regression analysis using scores on dissociation, hypnotizability and absorption showed them to be poor predictors of diagnosis; however, other analyses revealed that female gender, reports of multiple trauma incidents lasting months or years, initial seizure onset in late teens or twenties, and daily seizure attacks significantly differentiated PNES from ES patients. Thus, demographic and seizure variables proved to be much better predictors of diagnosis Richard Litwin is in Private Practice, Cleveland, OH. Etzel Cardeña is Chair and Associate Professor, Department of Psychology and Anthropology, University of Texas, Pan American. Address correspondence to: Etzel Cardeña, PhD, Chair, Department of Psychology and Anthropology, University of Texas, Pan American, 1201 West University Drive, Edinburg, TX 78539-2999 (E-mail: [email protected]). The authors wish to acknowledge the contribution of John A. Walker, PhD, during the study, and the valuable editorial suggestions of Elizabeth Bowman, MD. The editorial assistance of Nadia Webb, PhD, and Lorie Morris, MA, is also gratefully acknowledged. Journal of Trauma & Dissociation, Vol. 1(4) 200