Psychological and trauma-related differences in psychogenic nonepileptic seizures: An exploratory severity-based comparison.

OBJECTIVE

This study examined psychological and trauma-related characteristics of patients with psychogenic nonepileptic seizures (PNES) and explored whether a clinically informed severity grouping distinguished distinct psychosocial patterns. PNES patients were compared with individuals with epilepsy and healthy controls.

METHODS

Participants included mild PNES (n = 20), severe PNES (n = 28), epilepsy (n = 48), and healthy controls (n = 50). Assessments measured anxiety, depression, childhood trauma, dissociation, somatization, and alexithymia. PNES severity was defined using clinical indicators such as acute healthcare utilization and ictal motor intensity.

RESULTS

Both mild and severe PNES groups showed significantly higher anxiety scores than epilepsy patients and healthy controls (p < .01). Depression scores were highest in the mild PNES group and differed significantly from severe PNES, epilepsy, and healthy control groups (p < .05). Trauma profiles varied by severity: sexual abuse was more frequently reported in mild PNES, whereas physical abuse and emotional neglect were significantly higher in severe PNES (p < .05). Mild PNES patients also exhibited higher dissociation, somatization, and total alexithymia scores compared with severe PNES and healthy controls (all p < .05).

SIGNIFICANCE: Severity-linked clinical characteristics in PNES were associated with distinct trauma profiles and psychological symptom patterns. These exploratory findings highlighted the relevance of individualized psychological assessment and support the need for further research to validate severity-based distinctions.