Motivation, psychopathology, locus of control, and quality of life in women with epileptic and nonepileptic seizures

To examine factors that may potentially aid in the differential diagnosis and subsequent tailoring of treatment for patients with epileptic (ES) and psychogenic nonepileptic (PNES) seizures, thirty female patients with PNES and 51 female patients with temporal lobe epilepsy were assessed in the areas of motivation, psychopathology, health-related locus of control (HRLOC), and health-related quality of life (HRQOL). The two groups demonstrated equivalent levels of motivation, clinically elevated yet comparable mood symptoms, and no general differences in HRLOC. Despite similar mood disturbances in both groups, the participants with PNES had a later age of seizure onset, exhibited greater personality disturbances, attributed more control over their condition to nonphysicians, and endorsed a greater negative impact of their seizures on physical and emotional aspects of HRQOL. Preliminary analyses suggest that chronic anxiety and overall HRQOL may be core discriminators between these seizure groups. Addressing such issues may prove useful in tailoring more specific treatments for these etiologically disparate conditions.

► Both groups demonstrated equivalent motivation, elevated yet comparable mood symptoms and no general HRLOC differences. ► PNES patients demonstrated greater personality disturbances. ► PNES patients attributed greater control over their condition to non-physicians in comparison to TLE patients. ► PNES patients endorsed a greater negative impact of their seizures on physical and emotional aspects of HRQOL. ► Chronic anxiety and overall HRQOL were significant predictors of group membership.