Self-appraisal and objective assessment of cognitive and affective functioning in persons with epileptic and nonepileptic seizures

Subjective and objective assessments of cognitive and affective functioning of patients admitted to the EMU with epileptic (ES, n = 22) and psychogenic nonepileptic (NES, n = 23) seizures were compared. It was hypothesized that the patients with NES would overestimate their cognitive impairments and underestimate their affective disturbances relative to those with ES. Results revealed that the patients with NES reported greater word-finding difficulty than those with ES (P = 0.02), but performed better than the patients with ES on the Boston Naming Test (BNT, P = 0.03), suggesting a tendency to overestimate word-finding difficulty. Patients with NES and ES did not otherwise differ in subjective ratings of cognitive functions or emotional state; however, patients with NES performed worse on a test of affect expression/perception compared with those with ES (P = 0.02). For patients with NES, only performance on memory tests was significantly correlated with their anxiety level. Obtaining both subjective ratings and objective test findings of cognitive and affective functioning may help further differentiate between patients with NES and those with ES.