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Non-Epileptic Seizures and Other Functional Neurological Symptoms: Predisposing, Precipitating, and Perpetuating Factors

Received January 10, 2006; revised March 28, 2006; accepted April 11, 2006. From Sheffield Teaching Hospitals, NHS Trust Royal Hallamshire Hospital, Sheffield, S10 2JF, UK. Send correspondence and reprint requests to Markus Reuber, M.D., Ph.D., MRCP, Senior Clinical Lecturer in Neurology, Academic Neurology Unit, University of Sheffield Royal Hallamshire Hospital, Glossop Road, Sheffield, S10 2JF, UK. e-mail: mreuber{at}doctors.org.uk
© 2007 The Academy of Psychosomatic Medicine

This naturalistic study describes potential etiological factors in outpatients with functional neurological symptoms recorded during a screening interview with a single psychotherapist in 59 consecutive patients. The most commonly identified predisposing/precipitating factors were trauma (78.0%), family dysfunction (62.7%), and bereavement (62.7%). Family dysfunction (54.2%) and affective disorder (42%) were the commonest perpetuating factors. Trauma was more common in non-epileptic seizures; health anxiety, in men; family problems, in women. This study demonstrates the heterogeneity of this patient population. Further research is indicated to explore differences in predisposing, precipitating, and perpetuating factors in different patient groups with functional symptoms.

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