Psychological factors in the genesis and management of nonepileptic seizures: Clinical observations

Document Type

Article

Abstract

Nonepileptic seizures (NES) are frequently thought to have a "psychogenic" basis. Two 6-month group psychotherapy programs were provided for patients diagnosed as having NES [eight patients were treated during the first program, seven during the second (N = 15)] to explore the potential role of psychological factors in the genesis of NES and to determine if psychotherapeutic interventions reduced the frequency of NES. Of the 15 patients, 9 (60%) completed at least 58% of the treatment sessions. Of those 9 patients, 6 (66%) reported a decline in "seizure frequency." One reported an increase (11%). Self-reported frequency highly correlated with paranoid ideation. Dissociative phenomena were common as was a history of sexual abuse. Each patient reported being in an adult situation that they found unacceptable or intolerable. None perceived a solution to their situation. Reports by health care providers that their seizures were not "real" (i.e., true epilepsy) restimulated feelings associated with their not being believed when they reported being sexually abused as children. The psychological genesis of NES in this sample of patients appears rooted in the recurrent experience of being in abusive or exploited relationships for which they perceived no solution. © 2002 Elsevier Science (USA). All rights reserved.

Publication Date

8-1-2002

Publication Title

Epilepsy and Behavior

ISSN

15255050

Volume

3

Issue

4

First Page

343

Last Page

349

Digital Object Identifier (DOI)

10.1016/S1525-5050(02)00053-7

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