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August 11, 2020; 95 (6) Article

Mortality in patients with psychogenic nonepileptic seizures

View ORCID ProfileRussell Nightscales, Lara McCartney, Clarissa Auvrez, Gerard Tao, Sarah Barnard, View ORCID ProfileCharles B. Malpas, View ORCID ProfilePiero Perucca, View ORCID ProfileAnne McIntosh, View ORCID ProfileZhibin Chen, View ORCID ProfileShobi Sivathamboo, Sophia Ignatiadis, Simon Jones, Sophia Adams, View ORCID ProfileMark J. Cook, View ORCID ProfilePatrick Kwan, View ORCID ProfileDennis Velakoulis, View ORCID ProfileWendyl D'Souza, View ORCID ProfileSamuel F. Berkovic, View ORCID ProfileTerence J. O'Brien
First published July 20, 2020, DOI: https://doi.org/10.1212/WNL.0000000000009855
Russell Nightscales
From the Department of Neuroscience, Central Clinical School (R.N., S.B., C.B.M., P.P., Z.C., S.S., P.K., T.J.O.), and Clinical Epidemiology, School of Public Health and Preventive Medicine (Z.C.), Monash University, Melbourne; Departments of Medicine (R.N., C.A., G.T., C.B.M., P.P., A.M., Z.C., S.S., P.K., T.J.O.) and Neurology (R.N., C.A., G.T., C.B.M., P.P., S.S., P.K., T.J.O.) and Neuropsychiatry Unit (L.M., S.J., S.A., D.V.), The Royal Melbourne Hospital, and The Melbourne School of Psychological Sciences (C.B.M.), The University of Melbourne, Parkville; Department of Medicine (R.N.) and Epilepsy Research Centre, Department of Medicine (A.M., S.F.B.), Austin Health, The University of Melbourne, Heidelberg; Department of Neurology (C.B.M., P.P., A.M., S.S., P.K., T.J.O.), The Alfred Hospital, Melbourne; and Department of Medicine (S.I., M.J.C., W.D.), St. Vincent's Hospital, The University of Melbourne, Fitzroy, Australia.
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  • ORCID record for Russell Nightscales
Lara McCartney
From the Department of Neuroscience, Central Clinical School (R.N., S.B., C.B.M., P.P., Z.C., S.S., P.K., T.J.O.), and Clinical Epidemiology, School of Public Health and Preventive Medicine (Z.C.), Monash University, Melbourne; Departments of Medicine (R.N., C.A., G.T., C.B.M., P.P., A.M., Z.C., S.S., P.K., T.J.O.) and Neurology (R.N., C.A., G.T., C.B.M., P.P., S.S., P.K., T.J.O.) and Neuropsychiatry Unit (L.M., S.J., S.A., D.V.), The Royal Melbourne Hospital, and The Melbourne School of Psychological Sciences (C.B.M.), The University of Melbourne, Parkville; Department of Medicine (R.N.) and Epilepsy Research Centre, Department of Medicine (A.M., S.F.B.), Austin Health, The University of Melbourne, Heidelberg; Department of Neurology (C.B.M., P.P., A.M., S.S., P.K., T.J.O.), The Alfred Hospital, Melbourne; and Department of Medicine (S.I., M.J.C., W.D.), St. Vincent's Hospital, The University of Melbourne, Fitzroy, Australia.
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Clarissa Auvrez
From the Department of Neuroscience, Central Clinical School (R.N., S.B., C.B.M., P.P., Z.C., S.S., P.K., T.J.O.), and Clinical Epidemiology, School of Public Health and Preventive Medicine (Z.C.), Monash University, Melbourne; Departments of Medicine (R.N., C.A., G.T., C.B.M., P.P., A.M., Z.C., S.S., P.K., T.J.O.) and Neurology (R.N., C.A., G.T., C.B.M., P.P., S.S., P.K., T.J.O.) and Neuropsychiatry Unit (L.M., S.J., S.A., D.V.), The Royal Melbourne Hospital, and The Melbourne School of Psychological Sciences (C.B.M.), The University of Melbourne, Parkville; Department of Medicine (R.N.) and Epilepsy Research Centre, Department of Medicine (A.M., S.F.B.), Austin Health, The University of Melbourne, Heidelberg; Department of Neurology (C.B.M., P.P., A.M., S.S., P.K., T.J.O.), The Alfred Hospital, Melbourne; and Department of Medicine (S.I., M.J.C., W.D.), St. Vincent's Hospital, The University of Melbourne, Fitzroy, Australia.
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Gerard Tao
From the Department of Neuroscience, Central Clinical School (R.N., S.B., C.B.M., P.P., Z.C., S.S., P.K., T.J.O.), and Clinical Epidemiology, School of Public Health and Preventive Medicine (Z.C.), Monash University, Melbourne; Departments of Medicine (R.N., C.A., G.T., C.B.M., P.P., A.M., Z.C., S.S., P.K., T.J.O.) and Neurology (R.N., C.A., G.T., C.B.M., P.P., S.S., P.K., T.J.O.) and Neuropsychiatry Unit (L.M., S.J., S.A., D.V.), The Royal Melbourne Hospital, and The Melbourne School of Psychological Sciences (C.B.M.), The University of Melbourne, Parkville; Department of Medicine (R.N.) and Epilepsy Research Centre, Department of Medicine (A.M., S.F.B.), Austin Health, The University of Melbourne, Heidelberg; Department of Neurology (C.B.M., P.P., A.M., S.S., P.K., T.J.O.), The Alfred Hospital, Melbourne; and Department of Medicine (S.I., M.J.C., W.D.), St. Vincent's Hospital, The University of Melbourne, Fitzroy, Australia.
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Sarah Barnard
From the Department of Neuroscience, Central Clinical School (R.N., S.B., C.B.M., P.P., Z.C., S.S., P.K., T.J.O.), and Clinical Epidemiology, School of Public Health and Preventive Medicine (Z.C.), Monash University, Melbourne; Departments of Medicine (R.N., C.A., G.T., C.B.M., P.P., A.M., Z.C., S.S., P.K., T.J.O.) and Neurology (R.N., C.A., G.T., C.B.M., P.P., S.S., P.K., T.J.O.) and Neuropsychiatry Unit (L.M., S.J., S.A., D.V.), The Royal Melbourne Hospital, and The Melbourne School of Psychological Sciences (C.B.M.), The University of Melbourne, Parkville; Department of Medicine (R.N.) and Epilepsy Research Centre, Department of Medicine (A.M., S.F.B.), Austin Health, The University of Melbourne, Heidelberg; Department of Neurology (C.B.M., P.P., A.M., S.S., P.K., T.J.O.), The Alfred Hospital, Melbourne; and Department of Medicine (S.I., M.J.C., W.D.), St. Vincent's Hospital, The University of Melbourne, Fitzroy, Australia.
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Charles B. Malpas
From the Department of Neuroscience, Central Clinical School (R.N., S.B., C.B.M., P.P., Z.C., S.S., P.K., T.J.O.), and Clinical Epidemiology, School of Public Health and Preventive Medicine (Z.C.), Monash University, Melbourne; Departments of Medicine (R.N., C.A., G.T., C.B.M., P.P., A.M., Z.C., S.S., P.K., T.J.O.) and Neurology (R.N., C.A., G.T., C.B.M., P.P., S.S., P.K., T.J.O.) and Neuropsychiatry Unit (L.M., S.J., S.A., D.V.), The Royal Melbourne Hospital, and The Melbourne School of Psychological Sciences (C.B.M.), The University of Melbourne, Parkville; Department of Medicine (R.N.) and Epilepsy Research Centre, Department of Medicine (A.M., S.F.B.), Austin Health, The University of Melbourne, Heidelberg; Department of Neurology (C.B.M., P.P., A.M., S.S., P.K., T.J.O.), The Alfred Hospital, Melbourne; and Department of Medicine (S.I., M.J.C., W.D.), St. Vincent's Hospital, The University of Melbourne, Fitzroy, Australia.
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Piero Perucca
From the Department of Neuroscience, Central Clinical School (R.N., S.B., C.B.M., P.P., Z.C., S.S., P.K., T.J.O.), and Clinical Epidemiology, School of Public Health and Preventive Medicine (Z.C.), Monash University, Melbourne; Departments of Medicine (R.N., C.A., G.T., C.B.M., P.P., A.M., Z.C., S.S., P.K., T.J.O.) and Neurology (R.N., C.A., G.T., C.B.M., P.P., S.S., P.K., T.J.O.) and Neuropsychiatry Unit (L.M., S.J., S.A., D.V.), The Royal Melbourne Hospital, and The Melbourne School of Psychological Sciences (C.B.M.), The University of Melbourne, Parkville; Department of Medicine (R.N.) and Epilepsy Research Centre, Department of Medicine (A.M., S.F.B.), Austin Health, The University of Melbourne, Heidelberg; Department of Neurology (C.B.M., P.P., A.M., S.S., P.K., T.J.O.), The Alfred Hospital, Melbourne; and Department of Medicine (S.I., M.J.C., W.D.), St. Vincent's Hospital, The University of Melbourne, Fitzroy, Australia.
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Anne McIntosh
From the Department of Neuroscience, Central Clinical School (R.N., S.B., C.B.M., P.P., Z.C., S.S., P.K., T.J.O.), and Clinical Epidemiology, School of Public Health and Preventive Medicine (Z.C.), Monash University, Melbourne; Departments of Medicine (R.N., C.A., G.T., C.B.M., P.P., A.M., Z.C., S.S., P.K., T.J.O.) and Neurology (R.N., C.A., G.T., C.B.M., P.P., S.S., P.K., T.J.O.) and Neuropsychiatry Unit (L.M., S.J., S.A., D.V.), The Royal Melbourne Hospital, and The Melbourne School of Psychological Sciences (C.B.M.), The University of Melbourne, Parkville; Department of Medicine (R.N.) and Epilepsy Research Centre, Department of Medicine (A.M., S.F.B.), Austin Health, The University of Melbourne, Heidelberg; Department of Neurology (C.B.M., P.P., A.M., S.S., P.K., T.J.O.), The Alfred Hospital, Melbourne; and Department of Medicine (S.I., M.J.C., W.D.), St. Vincent's Hospital, The University of Melbourne, Fitzroy, Australia.
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Zhibin Chen
From the Department of Neuroscience, Central Clinical School (R.N., S.B., C.B.M., P.P., Z.C., S.S., P.K., T.J.O.), and Clinical Epidemiology, School of Public Health and Preventive Medicine (Z.C.), Monash University, Melbourne; Departments of Medicine (R.N., C.A., G.T., C.B.M., P.P., A.M., Z.C., S.S., P.K., T.J.O.) and Neurology (R.N., C.A., G.T., C.B.M., P.P., S.S., P.K., T.J.O.) and Neuropsychiatry Unit (L.M., S.J., S.A., D.V.), The Royal Melbourne Hospital, and The Melbourne School of Psychological Sciences (C.B.M.), The University of Melbourne, Parkville; Department of Medicine (R.N.) and Epilepsy Research Centre, Department of Medicine (A.M., S.F.B.), Austin Health, The University of Melbourne, Heidelberg; Department of Neurology (C.B.M., P.P., A.M., S.S., P.K., T.J.O.), The Alfred Hospital, Melbourne; and Department of Medicine (S.I., M.J.C., W.D.), St. Vincent's Hospital, The University of Melbourne, Fitzroy, Australia.
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Shobi Sivathamboo
From the Department of Neuroscience, Central Clinical School (R.N., S.B., C.B.M., P.P., Z.C., S.S., P.K., T.J.O.), and Clinical Epidemiology, School of Public Health and Preventive Medicine (Z.C.), Monash University, Melbourne; Departments of Medicine (R.N., C.A., G.T., C.B.M., P.P., A.M., Z.C., S.S., P.K., T.J.O.) and Neurology (R.N., C.A., G.T., C.B.M., P.P., S.S., P.K., T.J.O.) and Neuropsychiatry Unit (L.M., S.J., S.A., D.V.), The Royal Melbourne Hospital, and The Melbourne School of Psychological Sciences (C.B.M.), The University of Melbourne, Parkville; Department of Medicine (R.N.) and Epilepsy Research Centre, Department of Medicine (A.M., S.F.B.), Austin Health, The University of Melbourne, Heidelberg; Department of Neurology (C.B.M., P.P., A.M., S.S., P.K., T.J.O.), The Alfred Hospital, Melbourne; and Department of Medicine (S.I., M.J.C., W.D.), St. Vincent's Hospital, The University of Melbourne, Fitzroy, Australia.
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Sophia Ignatiadis
From the Department of Neuroscience, Central Clinical School (R.N., S.B., C.B.M., P.P., Z.C., S.S., P.K., T.J.O.), and Clinical Epidemiology, School of Public Health and Preventive Medicine (Z.C.), Monash University, Melbourne; Departments of Medicine (R.N., C.A., G.T., C.B.M., P.P., A.M., Z.C., S.S., P.K., T.J.O.) and Neurology (R.N., C.A., G.T., C.B.M., P.P., S.S., P.K., T.J.O.) and Neuropsychiatry Unit (L.M., S.J., S.A., D.V.), The Royal Melbourne Hospital, and The Melbourne School of Psychological Sciences (C.B.M.), The University of Melbourne, Parkville; Department of Medicine (R.N.) and Epilepsy Research Centre, Department of Medicine (A.M., S.F.B.), Austin Health, The University of Melbourne, Heidelberg; Department of Neurology (C.B.M., P.P., A.M., S.S., P.K., T.J.O.), The Alfred Hospital, Melbourne; and Department of Medicine (S.I., M.J.C., W.D.), St. Vincent's Hospital, The University of Melbourne, Fitzroy, Australia.
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Simon Jones
From the Department of Neuroscience, Central Clinical School (R.N., S.B., C.B.M., P.P., Z.C., S.S., P.K., T.J.O.), and Clinical Epidemiology, School of Public Health and Preventive Medicine (Z.C.), Monash University, Melbourne; Departments of Medicine (R.N., C.A., G.T., C.B.M., P.P., A.M., Z.C., S.S., P.K., T.J.O.) and Neurology (R.N., C.A., G.T., C.B.M., P.P., S.S., P.K., T.J.O.) and Neuropsychiatry Unit (L.M., S.J., S.A., D.V.), The Royal Melbourne Hospital, and The Melbourne School of Psychological Sciences (C.B.M.), The University of Melbourne, Parkville; Department of Medicine (R.N.) and Epilepsy Research Centre, Department of Medicine (A.M., S.F.B.), Austin Health, The University of Melbourne, Heidelberg; Department of Neurology (C.B.M., P.P., A.M., S.S., P.K., T.J.O.), The Alfred Hospital, Melbourne; and Department of Medicine (S.I., M.J.C., W.D.), St. Vincent's Hospital, The University of Melbourne, Fitzroy, Australia.
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Sophia Adams
From the Department of Neuroscience, Central Clinical School (R.N., S.B., C.B.M., P.P., Z.C., S.S., P.K., T.J.O.), and Clinical Epidemiology, School of Public Health and Preventive Medicine (Z.C.), Monash University, Melbourne; Departments of Medicine (R.N., C.A., G.T., C.B.M., P.P., A.M., Z.C., S.S., P.K., T.J.O.) and Neurology (R.N., C.A., G.T., C.B.M., P.P., S.S., P.K., T.J.O.) and Neuropsychiatry Unit (L.M., S.J., S.A., D.V.), The Royal Melbourne Hospital, and The Melbourne School of Psychological Sciences (C.B.M.), The University of Melbourne, Parkville; Department of Medicine (R.N.) and Epilepsy Research Centre, Department of Medicine (A.M., S.F.B.), Austin Health, The University of Melbourne, Heidelberg; Department of Neurology (C.B.M., P.P., A.M., S.S., P.K., T.J.O.), The Alfred Hospital, Melbourne; and Department of Medicine (S.I., M.J.C., W.D.), St. Vincent's Hospital, The University of Melbourne, Fitzroy, Australia.
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Mark J. Cook
From the Department of Neuroscience, Central Clinical School (R.N., S.B., C.B.M., P.P., Z.C., S.S., P.K., T.J.O.), and Clinical Epidemiology, School of Public Health and Preventive Medicine (Z.C.), Monash University, Melbourne; Departments of Medicine (R.N., C.A., G.T., C.B.M., P.P., A.M., Z.C., S.S., P.K., T.J.O.) and Neurology (R.N., C.A., G.T., C.B.M., P.P., S.S., P.K., T.J.O.) and Neuropsychiatry Unit (L.M., S.J., S.A., D.V.), The Royal Melbourne Hospital, and The Melbourne School of Psychological Sciences (C.B.M.), The University of Melbourne, Parkville; Department of Medicine (R.N.) and Epilepsy Research Centre, Department of Medicine (A.M., S.F.B.), Austin Health, The University of Melbourne, Heidelberg; Department of Neurology (C.B.M., P.P., A.M., S.S., P.K., T.J.O.), The Alfred Hospital, Melbourne; and Department of Medicine (S.I., M.J.C., W.D.), St. Vincent's Hospital, The University of Melbourne, Fitzroy, Australia.
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Patrick Kwan
From the Department of Neuroscience, Central Clinical School (R.N., S.B., C.B.M., P.P., Z.C., S.S., P.K., T.J.O.), and Clinical Epidemiology, School of Public Health and Preventive Medicine (Z.C.), Monash University, Melbourne; Departments of Medicine (R.N., C.A., G.T., C.B.M., P.P., A.M., Z.C., S.S., P.K., T.J.O.) and Neurology (R.N., C.A., G.T., C.B.M., P.P., S.S., P.K., T.J.O.) and Neuropsychiatry Unit (L.M., S.J., S.A., D.V.), The Royal Melbourne Hospital, and The Melbourne School of Psychological Sciences (C.B.M.), The University of Melbourne, Parkville; Department of Medicine (R.N.) and Epilepsy Research Centre, Department of Medicine (A.M., S.F.B.), Austin Health, The University of Melbourne, Heidelberg; Department of Neurology (C.B.M., P.P., A.M., S.S., P.K., T.J.O.), The Alfred Hospital, Melbourne; and Department of Medicine (S.I., M.J.C., W.D.), St. Vincent's Hospital, The University of Melbourne, Fitzroy, Australia.
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Dennis Velakoulis
From the Department of Neuroscience, Central Clinical School (R.N., S.B., C.B.M., P.P., Z.C., S.S., P.K., T.J.O.), and Clinical Epidemiology, School of Public Health and Preventive Medicine (Z.C.), Monash University, Melbourne; Departments of Medicine (R.N., C.A., G.T., C.B.M., P.P., A.M., Z.C., S.S., P.K., T.J.O.) and Neurology (R.N., C.A., G.T., C.B.M., P.P., S.S., P.K., T.J.O.) and Neuropsychiatry Unit (L.M., S.J., S.A., D.V.), The Royal Melbourne Hospital, and The Melbourne School of Psychological Sciences (C.B.M.), The University of Melbourne, Parkville; Department of Medicine (R.N.) and Epilepsy Research Centre, Department of Medicine (A.M., S.F.B.), Austin Health, The University of Melbourne, Heidelberg; Department of Neurology (C.B.M., P.P., A.M., S.S., P.K., T.J.O.), The Alfred Hospital, Melbourne; and Department of Medicine (S.I., M.J.C., W.D.), St. Vincent's Hospital, The University of Melbourne, Fitzroy, Australia.
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Wendyl D'Souza
From the Department of Neuroscience, Central Clinical School (R.N., S.B., C.B.M., P.P., Z.C., S.S., P.K., T.J.O.), and Clinical Epidemiology, School of Public Health and Preventive Medicine (Z.C.), Monash University, Melbourne; Departments of Medicine (R.N., C.A., G.T., C.B.M., P.P., A.M., Z.C., S.S., P.K., T.J.O.) and Neurology (R.N., C.A., G.T., C.B.M., P.P., S.S., P.K., T.J.O.) and Neuropsychiatry Unit (L.M., S.J., S.A., D.V.), The Royal Melbourne Hospital, and The Melbourne School of Psychological Sciences (C.B.M.), The University of Melbourne, Parkville; Department of Medicine (R.N.) and Epilepsy Research Centre, Department of Medicine (A.M., S.F.B.), Austin Health, The University of Melbourne, Heidelberg; Department of Neurology (C.B.M., P.P., A.M., S.S., P.K., T.J.O.), The Alfred Hospital, Melbourne; and Department of Medicine (S.I., M.J.C., W.D.), St. Vincent's Hospital, The University of Melbourne, Fitzroy, Australia.
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Samuel F. Berkovic
From the Department of Neuroscience, Central Clinical School (R.N., S.B., C.B.M., P.P., Z.C., S.S., P.K., T.J.O.), and Clinical Epidemiology, School of Public Health and Preventive Medicine (Z.C.), Monash University, Melbourne; Departments of Medicine (R.N., C.A., G.T., C.B.M., P.P., A.M., Z.C., S.S., P.K., T.J.O.) and Neurology (R.N., C.A., G.T., C.B.M., P.P., S.S., P.K., T.J.O.) and Neuropsychiatry Unit (L.M., S.J., S.A., D.V.), The Royal Melbourne Hospital, and The Melbourne School of Psychological Sciences (C.B.M.), The University of Melbourne, Parkville; Department of Medicine (R.N.) and Epilepsy Research Centre, Department of Medicine (A.M., S.F.B.), Austin Health, The University of Melbourne, Heidelberg; Department of Neurology (C.B.M., P.P., A.M., S.S., P.K., T.J.O.), The Alfred Hospital, Melbourne; and Department of Medicine (S.I., M.J.C., W.D.), St. Vincent's Hospital, The University of Melbourne, Fitzroy, Australia.
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Terence J. O'Brien
From the Department of Neuroscience, Central Clinical School (R.N., S.B., C.B.M., P.P., Z.C., S.S., P.K., T.J.O.), and Clinical Epidemiology, School of Public Health and Preventive Medicine (Z.C.), Monash University, Melbourne; Departments of Medicine (R.N., C.A., G.T., C.B.M., P.P., A.M., Z.C., S.S., P.K., T.J.O.) and Neurology (R.N., C.A., G.T., C.B.M., P.P., S.S., P.K., T.J.O.) and Neuropsychiatry Unit (L.M., S.J., S.A., D.V.), The Royal Melbourne Hospital, and The Melbourne School of Psychological Sciences (C.B.M.), The University of Melbourne, Parkville; Department of Medicine (R.N.) and Epilepsy Research Centre, Department of Medicine (A.M., S.F.B.), Austin Health, The University of Melbourne, Heidelberg; Department of Neurology (C.B.M., P.P., A.M., S.S., P.K., T.J.O.), The Alfred Hospital, Melbourne; and Department of Medicine (S.I., M.J.C., W.D.), St. Vincent's Hospital, The University of Melbourne, Fitzroy, Australia.
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Mortality in patients with psychogenic nonepileptic seizures
Russell Nightscales, Lara McCartney, Clarissa Auvrez, Gerard Tao, Sarah Barnard, Charles B. Malpas, Piero Perucca, Anne McIntosh, Zhibin Chen, Shobi Sivathamboo, Sophia Ignatiadis, Simon Jones, Sophia Adams, Mark J. Cook, Patrick Kwan, Dennis Velakoulis, Wendyl D'Souza, Samuel F. Berkovic, Terence J. O'Brien
Neurology Aug 2020, 95 (6) e643-e652; DOI: 10.1212/WNL.0000000000009855

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Abstract

Objective To investigate the hypothesis that patients diagnosed with psychogenic nonepileptic seizures (PNES) on video-EEG monitoring (VEM) have increased mortality by comparison to the general population.

Methods This retrospective cohort study included patients evaluated in VEM units of 3 tertiary hospitals in Melbourne, Australia, between January 1, 1995, and December 31, 2015. Diagnosis was based on consensus opinion of experienced epileptologists and neuropsychiatrists at each hospital. Mortality was determined in patients diagnosed with PNES, epilepsy, or both conditions by linkage to the Australian National Death Index. Lifetime history of psychiatric disorders in PNES was determined from formal neuropsychiatric reports.

Results A total of 5,508 patients underwent VEM. A total of 674 (12.2%) were diagnosed with PNES, 3064 (55.6%) with epilepsy, 175 (3.2%) with both conditions, and 1,595 (29.0%) received other diagnoses or had no diagnosis made. The standardized mortality ratio (SMR) of patients diagnosed with PNES was 2.5 (95% confidence interval [CI] 2.0–3.3). Those younger than 30 had an 8-fold higher risk of death (95% CI 3.4–19.8). Direct comparison revealed no significant difference in mortality rate between diagnostic groups. Among deaths in patients diagnosed with PNES (n = 55), external causes contributed 18%, with 20% of deaths in those younger than 50 years attributed to suicide, and “epilepsy” was recorded as the cause of death in 24%.

Conclusions Patients diagnosed with PNES have a SMR 2.5 times above the general population, dying at a rate comparable to those with drug-resistant epilepsy. This emphasizes the importance of prompt diagnosis, identification of risk factors, and implementation of appropriate strategies to prevent potential avoidable deaths.

Glossary

AIHW=
Australian Institute of Health and Welfare;
COD=
cause of death;
ICD-10=
International Classification of Diseases–10;
IRSAD=
Index of Relative Socioeconomic Advantage and Disadvantage;
NCIS=
National Coronial Information System;
NDI=
National Death Index;
PNES=
psychogenic nonepileptic seizures;
PNES + E=
psychogenic nonepileptic seizures and epilepsy;
RR=
risk ratio;
SMR=
standardized mortality ratio;
SUD=
sudden unexpected death;
SUDEP=
sudden unexpected death in epilepsy;
VEM=
video-EEG monitoring

Footnotes

  • Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • ↵* These authors contributed equally to this work.

  • Editorial, page 237

  • Podcast: NPub.org/i8i5ty

  • Received August 18, 2019.
  • Accepted in final form February 6, 2020.
  • © 2020 American Academy of Neurology
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Disputes & Debates: Rapid online correspondence

  • Author response: Mortality in patients with psychogenic nonepileptic seizures
    • Terence O'Brien, Neurologist, Monash University
    Submitted July 29, 2020
  • Reader response: Mortality in patients with psychogenic nonepileptic seizures
    • Nitin K. Sethi, Associate Professor of Neurology, New York-Presbyterian Hospital, Weill Cornell Medical Center (New York, NY)
    Submitted July 27, 2020
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