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Neurological Sciences

, Volume 40, Issue 3, pp 571–576 | Cite as

Utilization of the Patient Competency Rating Scale in an epileptic and non-epileptic veteran population

  • Jennifer M. Stinson
  • Jessica E. Chang
  • Jordan S. Robinson
  • Jesse S. Passler
  • Robert L. CollinsEmail author
Original Article
  • 108 Downloads

Abstract

Differentiating between epilepsy and psychogenic non-epileptic events (PNEE) can be difficult given similar presentations. PNEE is often misdiagnosed, resulting in unwarranted treatment with anti-epileptic drugs (AED). While the gold standard for differentiating PNEE from epilepsy is video EEG (VEGG) monitoring, self-reported symptomology has also been shown to discriminate between epilepsy and PNEE with high accuracy, particularly in cases where VEEG is difficult to obtain or when there are no observed events during extended monitoring. The Patient Competency Rating Scale (PCRS) was developed to measure the extent to which individuals are able to function in four domains: activities of daily living, emotional, interpersonal, and cognitive competency. Factor analyses validated the underlying factor structure of the PCRS in this seizure disorder sample. Follow-up MANOVA revealed group differences such that those diagnosed with PNEE reported less competence in all areas of functioning as compared to those diagnosed with epilepsy, with the largest difference being emotional competency. Secondary factor analyses were conducted for each diagnostic category. Two items related strongly to emotional competency loaded equally across the factors for those diagnosed with PNEE, indicating that emotional control is highly correlated with all areas of perceived competence for those with PNEE in this sample and may be considered as an intervention target. This was the first study to validate the use of the PCRS for a seizure disorder sample and to examine group differences in self-reported competency between those diagnosed with epilepsy and PNEE.

Keywords

Epilepsy Patient Competency Rating Scale Psychogenic non-epileptic events Seizure disorders 

Notes

Acknowledgements

This material is the result of work supported with resources and the use of facilities at Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX.

Compliance with ethical standards

The Institutional Review Board of the Michael E. DeBakey VA Medical Center (MEDVAMC) and Baylor College of Medicine approved this research and we have fully complied with the APA ethical standards throughout this research project.

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Fondazione Società Italiana di Neurologia 2019

Authors and Affiliations

  1. 1.Department of NeurologyBaylor College of MedicineHoustonUSA
  2. 2.San Francisco VA Health Care SystemSan FranciscoUSA
  3. 3.VA Puget Sound Health Care SystemTacomaUSA
  4. 4.Neurology Care Line (127), Michael E. DeBakey VA Medical Center, Department of NeurologyBaylor College of MedicineHoustonUSA

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