Mortality in patients with psychogenic non-epileptic seizures

Objective To investigate the hypothesis that patients diagnosed with 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 three tertiary hospitals in Melbourne, Australia, between January 1st, 1995 and December 31st, 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 (NDI). Lifetime history of psychiatric disorders in PNES was determined from formal neuropsychiatric reports.  Results 5,508 patients underwent VEM. 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 standardised mortality ratio (SMR) of patients d...研究目的：验证这一假说：经视频脑电监测（Video-EEG Monitoring, VEM）确诊为心因性非癫痫性发作（Psychogenic Non-epileptic Seizures, PNES）的患者，其死亡率高于普通人群。 研究方法：本回顾性队列研究纳入了1995年1月1日至2015年12月31日期间，在澳大利亚墨尔本三家三级医院的视频脑电监测中心接受评估的患者。诊断由各医院经验丰富的癫痫专科医师与神经精神科医师共同会诊确定。通过与澳大利亚国家死亡索引（National Death Index, NDI）进行关联比对，获取确诊为心因性非癫痫性发作、癫痫或同时罹患两种疾病的患者的死亡情况。心因性非癫痫性发作患者的终身精神疾病史，则通过正式的神经精神科评估报告进行确认。 研究结果：共计5508名患者接受了视频脑电监测检查。其中674例（12.2%）确诊为心因性非癫痫性发作（PNES），3064例（55.6%）确诊为癫痫，175例（3.2%）同时罹患两种疾病，另有1595例（29.0%）获得其他诊断或未明确诊断。患者的标准化死亡率比（Standardised Mortality Ratio, SMR）……