Abstract：
OBJECTIVE: To compare persons with epilepsy (PWE) to those with psychogenic non-epileptic seizures (PNES) on measures of depression, anxiety, and alexithymia subscales (i.e., difficulty identifying emotions, difficulty describing emotions, and external-oriented thinking).
METHODS: In this retrospective study, 235 epilepsy patients and 90 patients with PNES were evaluated between 2012 and 2020 at the Northeast Regional Epilepsy Group. These patients had completed the Toronto Alexithymia Scale (TAS-20), The Center for Epidemiologic Studies - Depression Scale (CES-D) and The State-Trait Anxiety Inventory (STAI). Background information was collected regarding work/student/disability status at the time of the evaluation history of psychiatric diagnosis; psychological trauma; and involvement in psychotherapy either at the time of the evaluation or prior.
RESULTS: Significant differences between PWEs and those with PNES were found not only in historical data (e.g., Psychiatric History, History of Trauma, and History of Therapy) (p < .001) but also on measures of Depression (p = .002) and Anxiety (p < .001). ANOVA analysis also revealed significant differences in the distribution of the TAS-Total score, TAS-Describing emotions, and TAS-Identifying emotions. Using logistic regression (stepwise model) the optimal set of predictors for a differential diagnosis of epilepsy and PNES was combination of TAS-Identifying emotions score, history of psychological trauma, and history of therapy. The accuracy of the prediction was determined to be 80.2 %.
CONCLUSIONS: Although higher alexithymia rates are present in PNES and PWEs, clinicians may find a combination of TAS-Identifying Emotion score, history of trauma, and history of psychotherapy useful in supporting a differential diagnosis. Also, a subgroup may exist among those with PNES with high levels of alexithymia, depression, and anxiety that may require a different treatment approach focused on addressing difficulties in identifying and describing their emotions and their other symptomatology.
METHODS: In this retrospective study, 235 epilepsy patients and 90 patients with PNES were evaluated between 2012 and 2020 at the Northeast Regional Epilepsy Group. These patients had completed the Toronto Alexithymia Scale (TAS-20), The Center for Epidemiologic Studies - Depression Scale (CES-D) and The State-Trait Anxiety Inventory (STAI). Background information was collected regarding work/student/disability status at the time of the evaluation history of psychiatric diagnosis; psychological trauma; and involvement in psychotherapy either at the time of the evaluation or prior.
RESULTS: Significant differences between PWEs and those with PNES were found not only in historical data (e.g., Psychiatric History, History of Trauma, and History of Therapy) (p < .001) but also on measures of Depression (p = .002) and Anxiety (p < .001). ANOVA analysis also revealed significant differences in the distribution of the TAS-Total score, TAS-Describing emotions, and TAS-Identifying emotions. Using logistic regression (stepwise model) the optimal set of predictors for a differential diagnosis of epilepsy and PNES was combination of TAS-Identifying emotions score, history of psychological trauma, and history of therapy. The accuracy of the prediction was determined to be 80.2 %.
CONCLUSIONS: Although higher alexithymia rates are present in PNES and PWEs, clinicians may find a combination of TAS-Identifying Emotion score, history of trauma, and history of psychotherapy useful in supporting a differential diagnosis. Also, a subgroup may exist among those with PNES with high levels of alexithymia, depression, and anxiety that may require a different treatment approach focused on addressing difficulties in identifying and describing their emotions and their other symptomatology.
摘要：
目的：比较癫痫患者（PWE）和精神性非癫痫发作患者（PNES）的抑郁程度。焦虑,和述情障碍分量表(即，难以识别情绪，难以描述情绪，和外部导向思维)。
方法：在这项回顾性研究中，在2012年至2020年期间，东北地区癫痫组评估了235例癫痫患者和90例PNES患者。这些患者完成了多伦多述情障碍量表（TAS-20），流行病学研究中心-抑郁量表（CES-D）和状态特质焦虑量表（STAI）。在评估精神病诊断史时，收集了有关工作/学生/残疾状况的背景信息；心理创伤；以及在评估时或之前参与心理治疗。
结果：不仅在历史数据中发现了PWE与PNES之间的显着差异（例如，精神病史,创伤的历史，和治疗史）（p<.001），以及抑郁（p=.002）和焦虑（p<.001）的测量。方差分析还显示，TAS-总分的分布存在显着差异，TAS-描述情绪，和TAS-识别情绪。使用逻辑回归（逐步模型），癫痫和PNES鉴别诊断的最佳预测因子集是TAS识别情绪评分的组合，心理创伤史,和治疗史。预测的准确度确定为80.2%。
结论：尽管PNES和PWE中存在较高的述情障碍率，临床医生可能会发现TAS识别情绪评分的组合，外伤史,和心理治疗史有助于支持鉴别诊断。此外，在患有高度述情障碍的PNES的人群中可能存在一个亚组，抑郁症,和焦虑，可能需要一种不同的治疗方法，专注于解决识别和描述他们的情绪和其他症状的困难。
方法：在这项回顾性研究中，在2012年至2020年期间，东北地区癫痫组评估了235例癫痫患者和90例PNES患者。这些患者完成了多伦多述情障碍量表（TAS-20），流行病学研究中心-抑郁量表（CES-D）和状态特质焦虑量表（STAI）。在评估精神病诊断史时，收集了有关工作/学生/残疾状况的背景信息；心理创伤；以及在评估时或之前参与心理治疗。
结果：不仅在历史数据中发现了PWE与PNES之间的显着差异（例如，精神病史,创伤的历史，和治疗史）（p<.001），以及抑郁（p=.002）和焦虑（p<.001）的测量。方差分析还显示，TAS-总分的分布存在显着差异，TAS-描述情绪，和TAS-识别情绪。使用逻辑回归（逐步模型），癫痫和PNES鉴别诊断的最佳预测因子集是TAS识别情绪评分的组合，心理创伤史,和治疗史。预测的准确度确定为80.2%。
结论：尽管PNES和PWE中存在较高的述情障碍率，临床医生可能会发现TAS识别情绪评分的组合，外伤史,和心理治疗史有助于支持鉴别诊断。此外，在患有高度述情障碍的PNES的人群中可能存在一个亚组，抑郁症,和焦虑，可能需要一种不同的治疗方法，专注于解决识别和描述他们的情绪和其他症状的困难。
