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3 results on '"Haenen, Alexandra I."'

1. Psychogenic non‐epileptic (functional) seizures in adults with intellectual disability and epilepsy: A matched case–control study.

Author

Kloosterman, Iris E. M., Haenen, Alexandra I., Poortvliet‐Koedam, Esther L. G. E., Lazeron, Richard H. C., Schelhaas, Helenius J., and van Ool, Jans S.

Subjects
*LIFE change events, *PSYCHOSOCIAL functioning, *MENTAL illness, *PEOPLE with epilepsy, *INTELLECTUAL disabilities, *EPILEPSY, *PSYCHOGENIC nonepileptic seizures
Abstract

Objective: To describe the characteristics of psychogenic non‐epileptic (functional) seizures (PNES) in adults with epilepsy and intellectual disability (ID) and to establish differences and risk factors regarding psychosocial functioning between individuals with and without PNES. Methods: Adults with ID and epilepsy living in epilepsy care facilities in The Netherlands were screened for PNES by a neurologist. A control group consisting of people with epilepsy and ID, without PNES, was matched according to age, sex, and level of ID. Objective data were retrieved retrospectively from clinical notes of the resident. Standardized questionnaires and tests, adjusted for people with ID, were obtained from participants and their nursing staff. Differences were analyzed using paired t tests, Wilcoxon signed‐rank tests, or McNemar's tests, appropriate for matched case–control studies. Conditional logistic regression identified PNES risk factors. Results: Five hundred forty individuals were screened, of which 42 had PNES (point prevalence 7.8%). In total, 35 cases and 35 controls gave consent. Proxy reports indicated that PNES impacted daily life in 79% by adjusting the individual's schedule, and caused minor injuries in one‐third. Those with PNES were mainly female (69%); had a mild (46%) or moderate (37%) level of ID; showed more symptoms of depression (p =.024), anxiety (p =.030), self‐injurious behavior (p =.015); and experienced more negative life events (p <.001). Clinically relevant predictors of PNES were the number of negative life events (odds ratio [OR] 1.71, 95% confidence interval [CI] 1.12–2.53) and self‐injurious behaviors (OR 5.27, 95% CI.97–28.81). Significance: Previously, PNES in individuals with ID and epilepsy were described mainly as a reinforced behavioral pattern, due to limited associations with psychiatric disorders. Our results demonstrate that this population does show individual psychosocial vulnerabilities when measured with instruments adjusted for this population, as indicated by proxy reports from daily caregivers. Viewing PNES as an involuntary response, especially for stress‐prone individuals with ID, could reduce stigma and improve treatment. [ABSTRACT FROM AUTHOR]

Published
2024
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2. Psychogenic nonepileptic seizures in adults with epilepsy and intellectual disability: A neglected area

Author

van Ool, Jans S., van Ool, Jans S., Haenen, Alexandra I., Snoeijen-Schouwenaars, Francesca M., Aldenkamp, Albert P., Hendriksen, Jos G. M., Schelhaas, H. Jurgen, Tan, In Y., Lazeron, Richard H. C., Bodde, Nynke M. G., van Ool, Jans S., van Ool, Jans S., Haenen, Alexandra I., Snoeijen-Schouwenaars, Francesca M., Aldenkamp, Albert P., Hendriksen, Jos G. M., Schelhaas, H. Jurgen, Tan, In Y., Lazeron, Richard H. C., and Bodde, Nynke M. G.

Abstract

Purpose: To describe the main characteristics of psychogenic nonepileptic seizures (PNES) in adults with epilepsy and intellectual disability (ID), and to analyse the differences regarding psychosocial functioning, epilepsy severity and ID between patients with PNES and a control group without PNES. Methods: Medical records of adults with ID and epilepsy living at an epilepsy care facility (N = 240) were screened for PNES and evaluated by a neurologist. A control group consisting of patients with epilepsy and ID, without PNES, was matched according to age, sex and level of ID. Characteristics of PNES and epilepsy were provided by the subject's nursing staff or retrieved from patient charts, psychosocial data were collected by standardised questionnaires and level of ID was individually assessed using psychometric instruments. Results: The point prevalence of PNES was 7.1%. The patients with PNES (n = 15) were most often female and had a mild or moderate level of ID. Compared to controls, they showed more depressive symptoms, experienced more negative life events and had more often an ID discrepancy (ID profile with one domain particularly more impaired than another). Stress-related triggers were recognised in a large majority by the nursing staff. Conclusion: PNES appears to be a relatively rare diagnostic entity among inpatients with both epilepsy and ID. However, the complexity of diagnosing PNES in this population, and the similarities in stress related triggers for PNES in patients with and without ID, suggest that PNES may be underdiagnosed in the ID population. Diagnostic challenges of PNES and, as subcategory, reinforced behavioural patterns are discussed. (C) 2018 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Published
2018

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