Long-term adherence with psychiatric treatment among patients with psychogenic nonepileptic seizures.
We conducted a prospective cohort study, examining long-term adherence with psychiatric treatment among patients with psychogenic nonepileptic seizures (PNES). Subjects diagnosed with documented PNES were scheduled for 4 psychiatric visits. Survival analysis was performed, and covariates were assessed for association with time to nonadherence using Cox proportional hazard regression analysis. One hundred twenty-three subjects were recruited and followed for up to 17 months. Eighty percent of subjects attended the first outpatient visit, 42% attended the second, 24% attended the third, and only 14% remained adherent through the fourth visit. Two covariates were associated with nonadherence: (1) a prior diagnosis of PNES (hazard ratio 1.57, P-value .046); (2) a lower score on the Brief Illness Perception Questionnaire (BIPQ), signifying lower concern about one's illness (hazard ratio 0.77 for every 10-point increment on the 80-point scale, P-value .008). Adherence with psychiatric treatment among patients with PNES is initially reasonably good but worsens rapidly over visits 2-4. Risk factors for nonadherence include a history of a prior diagnosis of PNES, and a lower level of concern about the illness as assessed by a lower score on the BIPQ.
['Tolchin|Benjamin|B|0000-0002-9099-0022', 'Dworetzky|Barbara A|BA|', 'Baslet|Gaston|G|']
D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D015331:Cohort Studies D004569:Electroencephalography D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D010349:Patient Compliance D011602:Psychophysiologic Disorders D011613:Psychotherapy D012640:Seizures D016896:Treatment Outcome D055815:Young Adult
PNES compliance conversion disorder functional neurological symptom disorder nonepileptic attack disorder