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dc.contributor.authorWang, Albert D-
dc.contributor.authorLeong, Michelle-
dc.contributor.authorJohnstone, Benjamin-
dc.contributor.authorRayner, Genevieve-
dc.contributor.authorKalincik, Tomas-
dc.contributor.authorRoos, Izanne-
dc.contributor.authorKwan, Patrick-
dc.contributor.authorO'Brien, Terence J-
dc.contributor.authorVelakoulis, Dennis-
dc.contributor.authorMalpas, Charles B-
dc.identifier.citationEpilepsy research 2019; 158: 106234-
dc.description.abstractSimilarities in clinical presentations between epileptic seizures (ES) and psychogenic non-epileptic seizures (PNES) produces a risk of misdiagnosis. Video-EEG monitoring (VEM) is the diagnostic gold standard, but involves significant cost and time commitment, suggesting a need for efficient screening tools. 628 patients were recruited from an inpatient VEM unit; 293 patients with ES, 158 with PNES, 31 both ES and PNES, and 146 non-diagnostic. Patients completed the SCL-90-R, a standardised 90-item psychopathology instrument. Bayesian linear models were computed to investigate whether SCL-90-R domain scores or the overall psychopathology factor p differed between groups. Receiver operating characteristic (ROC) curves were computed to investigate the PNES classification accuracy of each domain score and p. A machine learning algorithm was also used to determine which subset of SCL-90-R items produced the greatest classification accuracy. Evidence was found for elevated scores in PNES compared to ES groups in the symptom domains of anxiety (b = 0.47, 95%HDI = [0.10, 0.80]), phobic anxiety (b = 1.32, 95%HDI = [0.98, 1.69]), somatisation (b = 0.84, 95%HDI = [0.49, 1.20]), and the general psychopathology factor p (b = 1.35, 95%HDI = [0.86, 1.82]). Of the SCL-90-R domain scores, somatisation produced the highest classification accuracy (AUC = 0.74, 95%CI = [0.69, 0.79]). The genetic algorithm produced a 6-item subset from the SCL-90-R, which produced comparable classification accuracy to the somatisation scores (AUC = 0.73, 95%CI = [0.64, 0.82]). Compared to patients with ES, patients with PNES report greater symptoms of somatisation, general anxiety, and phobic anxiety against a background of generally elevated psychopathology. While self-reported psychopathology scores are not accurate enough for diagnosis in isolation, elevated psychopathology in these domains should raise the suspicion of PNES in clinical settings.-
dc.subjectEpileptic seizures-
dc.subjectMachine learning-
dc.subjectPsychiatric comorbidity-
dc.subjectPsychogenic non-epileptic seizures-
dc.titleDistinct psychopathology profiles in patients with epileptic seizures compared to non-epileptic psychogenic seizures.-
dc.typeJournal Article-
dc.identifier.journaltitleEpilepsy research-
dc.identifier.affiliationClinical Outcomes Research Unit (CORe), Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Australia-
dc.identifier.affiliationDepartment of Medicine, Royal Melbourne Hospital, The University of Melbourne, Australia-
dc.identifier.affiliationMelbourne School of Psychological Sciences, The University of Melbourne, Australiaen
dc.identifier.affiliationDepartment of Neurology, Alfred Health, Australiaen
dc.identifier.affiliationDepartment of Neurosciences, Monash University, Australiaen
dc.identifier.affiliationDepartment of Medicine, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australiaen
dc.identifier.affiliationDepartment of Psychiatry, The University of Melbourne, Australiaen
dc.identifier.affiliationDepartment of Psychiatry, Royal Melbourne Hospital, Australiaen
dc.identifier.affiliationDepartment of Medicine, Royal Melbourne Hospital, The University of Melbourne, Australiaen
dc.identifier.affiliationDepartment of Neurology, Royal Melbourne Hospital, Australiaen
dc.type.austinJournal Article-, Genevieve
item.fulltextNo Fulltext-
item.openairetypeJournal Article- Florey Institute of Neuroscience and Mental Health-
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