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Suicidality and relation with dissociation and alexithymia in PNES and conversion disorder

Published online by Cambridge University Press:  13 August 2021

L. Longo ,
T. Jannini ,
M. Merlo ,
C. Bombacci ,
M.R. Biancolino ,
R. Rossi ,
E. Di Carlo ,
C. Niolu ,
A. Siracusano  and
G. Di Lorenzo
L. Longo*
Affiliation:
Department Of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
T. Jannini
Affiliation:
Department Of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
M. Merlo
Affiliation:
Department Of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
C. Bombacci
Affiliation:
Department Of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
M.R. Biancolino
Affiliation:
Department Of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
R. Rossi
Affiliation:
Department Of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
E. Di Carlo
Affiliation:
Department Of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
C. Niolu
Affiliation:
Department Of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
A. Siracusano
Affiliation:
Department Of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
G. Di Lorenzo
Affiliation:
Department Of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
*
*Corresponding author.

Abstract

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Introduction

Amongst different subtypes of Conversion Disorder (CD), DSM-V lists the Psychogenic Non-epileptic seizures (PNES). PNES are defined as episodes that visually resemble epileptic seizures but, etiologically, they are not due to electrical discharges in the brain.

Objectives

Our study aims to explore the differences between PNES and other CDs. In particular, we studied the suicidality and its correlations with dissociation and alexithymia.

Methods

Patients, recruited from the Psychiatry and Clinical Psychology Unit of the Fondazione Policlinico Tor Vergata, Rome, Italy, were diagnosed with PNES (n=22) and CD (n=16) using the DSM-5 criteria. Patients underwent the following clinical assessments: HAM-D, BDI, DES, BHS, TAS, CTQ.

Results

PNES showed significantly higher scores than CD in all assessments, except for BDI-somatic (p=0.39), BHS-feeling (p=0.86), and the presence of childhood trauma. PNES also showed significantly higher suicidality (p = 0.003). By controlling for the confounding factor “depression”, in PNES suicidality (and in particular the BHS-loss of motivation) appears to be correlated with DES-total score (p = 0.008), DES-amnesia (p = 0.002) and DES -derealization-depersonalization (p = 0.003). On the other hand, in CDs, the BHS-total score shows a correlation with the TAS-total score (p = 0.03) and BHS-Feelings with TAS-Externally-Oriented Thinking (p = 0.035), while only the BHS-Loss of motivation appears correlated with DES-Absorption (p = 0.011).

Conclusions

Our study shows significant differences between PNES and CD, in several symptomatologic dimensions, including suicidality. Indeed, in PNES suicidality appears to be related to dissociation, while in CDs it appears mainly to be correlated with alexithymia.

Keywords

Psychogenic non-epileptic seizuresSuicidalityPNESconversion disorder
Type
Abstract
Information
European Psychiatry , Volume 64 , Special Issue S1: Abstracts of the 29th European Congress of Psychiatry , April 2021 , pp. S591
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
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