Using personality disorders to distinguish between patients with psychogenic nonepileptic seizures and those with epileptic seizures

Identifying psychiatric disorders rather than psychiatric symptoms might help to distinguish patients with psychogenic nonepileptic seizures (PNES) from those with epileptic seizures (ES). Patients with PNES (n = 35), patients with ES (n = 35), and healthy controls (n = 37) were compared with respect to the prevalence of psychiatric disorders in this study. We tested the predictive power of having axis I psychiatric disorders, as well as personality disorders, in distinguishing ES from PNES. There was no significant difference between the patient groups in the prevalence of axis I psychiatric disorders. Personality disorders were more prevalent in the PNES group than in the ES group (P < 0.05). Having a personality disorder was the only predictor for the PNES group. Having a personality disorder seems to be a more significant predictor for PNES than having an axis I psychiatric disorder. Greater attention should be paid to personality disorders in the differentiation of PNES and ES and the provision of effective treatment.

► Assessment of personality disorders may contribute to identifying patients with psychogenic nonepileptic seizures.
► Personality disorders are more common in patients with psychogenic nonepileptic seizures.
► The most common cluster is cluster B personality disorders in psychogenic nonepileptic seizures.
► Having a personality disorder is a significant predictor of being in the psychogenic nonepileptic seizure group.