Psychogenic nonepileptic seizures and suicidal behavior on a video/EEG telemetry unit: the need for psychiatric assessment and screening for suicide risk |
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Authors: | Kaufman Kenneth R Struck Peter J |
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Institution: | a Department of Psychiatry, UMDNJ—Robert Wood Johnson Medical School, New Brunswick, NJ, USA;b Department of Neurology, UMDNJ—Robert Wood Johnson Medical School, New Brunswick, NJ, USA;c Department of Anesthesiology, UMDNJ—Robert Wood Johnson Medical School, New Brunswick, NJ, USA |
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Abstract: | Patients with epilepsy and psychogenic nonepileptic seizures (PNES) have an increased prevalence of psychiatric illness and risk for suicidal ideation/suicidal behavior/suicide compared with the general population. Recent literature suggests that antiepileptic drugs (AEDs) used to treat epilepsy, pain, and psychiatric disorders increase the risk of suicide and that this increased risk may be AED selective. This case analyzes a suicide attempt on a video/EEG telemetry unit. Specific risk factors associated with increased risk of suicidal behaviors pertinent to this case are reviewed: epilepsy, multiple psychiatric diagnoses including affective disorder, AEDs, PNES, prior medically serious suicide attempt, and suicide attempt within the past month. Specific psychometric rating scales to screen for both psychiatric illness and suicide risk and psychiatric assessment should be integral components of the evaluation and treatment of patients on video/EEG telemetry units. |
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Keywords: | Suicidal behavior Video EEG telemetry unit Epilepsy Psychogenic nonepileptic seizures Antiepileptic drugs Psychiatric comorbidity Depression Obsessive– compulsive disorder Panic disorder Posttraumatic stress disorder Pain Prevalence Psychometric rating scales Safety Education |
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