ArticleNeurology2020
Mortality in patients with psychogenic nonepileptic seizures.
2 registry-linked trialsOpen access · greenAbstract readMulticenter Study
In one paragraph
Article in Neurology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 53 papers, 1 of them a synthesis that pooled it.
0numbers the graph read from it
0cells of the map it votes in
53citing papers in PubMed, 1 pooled it
11.5field-weighted citation impact, top 1% of its field
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Controlled Clinical Trial of Transcranial Magnetic Stimulation Versus Conventional Therapy for the Treatment of Functional Neurological Non-Epileptic Seizure Disorder: A Pilot Study
NCT07059325 early_phase1recruitingnot on this mapstarted 2025, after this paper: background citation
Accelerated, Left Prefrontal Transcranial Magnetic Stimulation for Functional Seizures; An Open-Label Exploration of Feasibility, Tolerability, and Preliminary Efficacy
Who cites it
53 citing papers in PubMed, 1 synthesis or guideline pooled it, 116 citations in OpenAlex.
- The neurobiology of functional neurological disorders characterised by impaired awareness.Frontiers in psychiatry · 2023Pooled it
- Mortality in functional seizures: Evidence from a large electronic health records dataset.Epilepsia · 2026Article
- Quantifying the impact of a computer-aided diagnostic score on the clinical diagnosis of functional seizures.Epilepsia · 2026Article
- Pupillary Dilation in an Adolescent With Psychogenic Non-epileptic Seizures: A Case Report.Cureus · 2026Article
- Article
- Functional/dissociative seizures in a single women's rehabilitation center in Addis Ababa, Ethiopia: a single-center case series and thematic analysis of neuropsychiatric presentation, cultural meaning, and structural barriers to care.Frontiers in psychiatry · 2026Article
- The heartbeat evoked potential and the prediction of functional seizure semiology.Brain communications · 2026Article
- Beyond the spike: Functional (dissociative) seizures as a key to holistic attitudes in seizure disorders.Epilepsia · 2026Review
- Development of a qualitative data analysis codebook for peri-ictal behavior in suspected functional seizures.Epilepsia · 2025Article
- Ten-year projection of adult epilepsy burden in Australia.Epilepsia · 2025Article
- Functional neurological disorder: Practical management.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2025Review
- Clinical Characteristics associated with functional seizures in individuals with psychosis.Schizophrenia research · 2025Article
- Use of an Electronic Medical Record Alert to Prevent Iatrogenic Interventions in Patients With Psychogenic Nonepileptic Seizures.Neurology. Clinical practice · 2025Article
- Supervised machine learning compared to large language models for identifying functional seizures from medical records.Epilepsia · 2025Article
- Iatrogenic harm in functional neurological disorder.Brain : a journal of neurology · 2025Review
- Functional Neurologic Disorder,Neurology · 2024Article
- A Retrospective Study Reviewing Timing to Onset of Habitual Psychogenic Non-Epileptic Seizures in a Home Video Telemetry Cohort.Brain sciences · 2024Article
- Exploring therapeutic interventions for functional neurological disorders: a comprehensive scoping review.Journal of neurology · 2024Article
- Sociodemographic and clinical risk factors for suicidal ideation and suicide attempt in functional/dissociative seizures and epilepsy: a large cohort study.BMJ mental health · 2024Article
- Elevated Mortality Rate in Patients With Functional Seizures After Diagnosis and Referral.Neurology. Clinical practice · 2024Article
Corrections and comments
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Authors and funding
19 authors at 1 institution in 2 countries.
Russell NightscalesFrom 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.ORCID 0000-0001-9108-207X
Lara McCartneyFrom 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.
Clarissa AuvrezFrom 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.
Gerard TaoFrom 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.
Sarah BarnardFrom 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.
Charles B MalpasFrom 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.ORCID 0000-0003-0534-3718
Piero PeruccaFrom 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.ORCID 0000-0002-7855-7066
Anne McIntoshFrom 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.ORCID 0000-0002-5020-260X
Zhibin ChenFrom 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.ORCID 0000-0002-1888-6917
Shobi SivathambooFrom 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.ORCID 0000-0003-4638-9579
Sophia IgnatiadisFrom 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.
Simon JonesFrom 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.
Sophia AdamsFrom 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.
Mark J CookFrom 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.ORCID 0000-0002-8875-4135
Patrick KwanFrom 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.ORCID 0000-0001-7310-276X
Dennis VelakoulisFrom 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.ORCID 0000-0002-8842-8479
Wendyl D'SouzaFrom 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.ORCID 0000-0002-1750-5131
Samuel F BerkovicFrom 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.ORCID 0000-0003-4580-841X
Terence J O'BrienFrom 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. terence.obrien@monash.edu.ORCID 0000-0002-7198-8621
The University of Melbourne · AU
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo 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.
methodsThis 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.
resultsA 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%.
conclusionsPatients 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.
Indexed as
AdolescentAdultAge DistributionAnxiety DisordersCause of DeathChildChild, PreschoolComorbidityConversion DisorderDepressive DisorderDiagnosis-Related GroupsDissociative DisordersElectroencephalographyEpilepsyFemaleHumans
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