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American Epilepsy Society Poster Session #: 1.088 Depression, Anxiety and Quality of Life in Hispanic Spanish-speaking patients with psychogenic non-epileptic seizures (PNES) compared to those with epilepsy

Lorna Myers and Ruifan Zeng

Rationale: Lower quality of life and greater psychopathology in patients with PNES as compared to patients with medically intractable epilepsy have consistently been reported in the literature. To date, these same psychological measures have not been examined in in Spanish-speaking US immigrants diagnosed with PNES or epilepsy. Cultural and linguistic features can confer considerable differences in the presentation of psychopathology and is a crucial variable to examine. The aim of this study was to compare Hispanic, Spanish-speaking patients diagnosed with psychogenic non-epileptic seizures (PNES) to patients with epilepsy on measures of depression, anxiety, and quality of life.

Methods: Video-EEG monitoring was utilized to confirm a diagnosis of PNES in 12 adults and a diagnosis of epilepsy in 31 adults. All patients were predominantly Spanish-speaking and were administered our standard Spanish testing battery, which includes the Beck Depression Inventory II (BDI-II), Beck Anxiety Inventory (BAI), and Quality of Life in Epilepsy-31 (QOLIE-31). Chart review was used to gather information on seizure disorder duration, country of origin, and years since immigration. All patients were immigrants from Central and South America or the Caribbean. Patients with a dual diagnosis of PNES and epilepsy were excluded.

Results: Of the 12 PNES patients, 11 were females. Mean age at the time of study was 48.67 years (±4.25), mean education was 9.67 (±1.51), and mean years living in the US was 16.58 (±2.94). Of the patients with epilepsy, 20 were females, with a mean age of 42.81 years (±2.34), mean education of 11.18 (±.54) years, and mean years in the US of 17.80 (±2.10). Patients with PNES differed from the patients with epilepsy in expressing significantly higher anxiety scores on the BAI (p=.000, t= 6.025, group 1 mean: 35.20 +- 3.966 (SEM) and group 2 mean: 13.16 +- 1.649). There were no other significant differences found between groups with respect to depression, quality of life, or demographic and seizure characteristics.

Conclusions: We found that Spanish-speaking Hispanic patients diagnosed with PNES reported significantly more anxious symptomatology than Spanish-speaking Hispanic patients diagnosed with epilepsy. Contrary to published reports that have examined non-Hispanic samples, we observed no differences on measures of depression and quality of life. To our knowledge, the present study is the first of its kind to examine anxiety, depression and quality of life in Spanish-speaking US immigrants with PNES or epilepsy. Gaining a better understanding of psychological health in Hispanics diagnosed with PNES or epilepsy is important given that language barriers, ethnicity and migration can represent critical variables in these patients' eventual psychiatric status.