Psychiatric and personality factors in pediatric functional seizures: A prospective case-control study
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Purpose This study assessed psychiatric and personality characteristics in relation to pediatric functional seizures (FS).Methods In a 1:1 prospectively matched-control study design, children with documented FS (confirmed via video EEG; ages 13-18) were matched to controls (MCs) on income, sex, race, and age. Primary outcomes were Behavior Assessment System for Children, Second Edition (BASC-2) and Millon Adolescent Clinical Inventory (MACI). Secondary measures included questionnaires assessing trauma, somatization, body awareness and quality of life (QOL). T-tests investigated differences between groups on T-scores. Due to lack of significant outcomes, an experimental analysis was conducted assessing differences in number of clinically elevated BASC-2 and MACI scores between groups. Binary logistic regressions determined the influences of clinically elevated scores on likelihood participants have FS. T-tests assessed differences on secondary measures.Results Participants included 84 children, 42 with FS and 42 MCs (Children with FS: Mean age=15.4, Interquartile Range age=3; 73.5% female; 59.5% white). Children with FS had greater parent-reported somatization (t(23)=5.67, p<0.001) on BASC-2, greater somatization on CSSI-24 (t(35)=6.83, p<0.001), and poorer QOL (t(41)=-6.22; p<0.001) than MCs. There were no differences in clinically elevated BASC-2 or MACI scores compared to MCs and clinically elevated scores did not influence likelihood participants have FS.Conclusions Children with FS had greater somatization and poorer QOL but similar rates of psychiatric symptoms, trauma, and maladaptive personality traits compared to MCs. Psychiatric or personality factors did not predict likelihood of FS. Explanations of pediatric FS should consider novel contributors to FS rather than relying solely on a psychiatric etiology.
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In a different study using the MACI with children with functional seizures (n = 42), no differences between patients and controls were found.
“In a different study using the MACI with children with functional seizures (n = 42), no differences between patients and controls were found [64].”
From Illness-Promoting Psychological Processes in Children and Adolescents with Functional Neurological Disorder (2023) · cites this paper as [64]
The Results report no differences between children with functional seizures and matched controls on MACI self-report subscales. They also specify that the study enrolled 42 children with functional seizures, but the MACI outcome sample was 42 participants total—not 42 children with functional seizures. The quoted sample size is therefore misleading if it refers to those who completed the MACI. (LLM, conf=0.87)
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- [16]Kozlowska K, Sawchuk T, Waugh JL, Changing the Culture of Care for Children and Adolescents with Functional Neurological Disorder. Epilepsy & Behavior Reports. 2021: 100486. doi: 10.1016/j.ebr.2021.100486 PMC8567196 34761194 · DOI · Paper page
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Stager, L., Morriss, S., McKibben, L., Grant, M., Szaflarski, J. P., & Fobian, A. D. (2022) · Seizure · doi:10.1016/j.seizure.2022.03.021 · Cited by 21 · see citing works
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Self-citation
- Authors
- Stager, L., Morriss, S., Szaflarski, J. P., & Fobian, A. D.
- Affiliations
- University of Alabama at Birmingham (US)
- Corresponding author
- Fobian, Aaron D.
- Venue
- Seizure
- Publisher
- Elsevier BV
- Published
- 2022-05
- Volume
- 98
- Pages
- 105-112
- ISSN
- 1059-1311 (ISSN-L)
- PMC
- PMC9081249
- OpenAlex
- W4224036250
- Cited by
- 22
- References
- 50
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 4 · 2023: 6 · 2022: 1
- FWCI
- 2.77
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Seizure (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Department of Defense (EP160028)
- National Institute of Mental Health (R61MH127155)
- National Institute of Diabetes and Digestive and Kidney Diseases (K23DK106570)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Epilepsy research and treatment
- Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
- Keywords
- psychiatric comorbidity, personality traits, somatization, quality of life, trauma, maladaptive personality, Behavior Assessment System for Children, Millon Adolescent Clinical Inventory, children and adolescents
- MeSH terms
- Adolescent, Child, Female, Humans, Male, Personality, Quality of Life, Surveys and Questionnaires, Seizures, Case-Control Studies
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