Psychiatric and personality factors in pediatric functional seizures: A prospective case-control study, 2022, Stager, Fobian et al

Abstract

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: Meanage=15.4, Interquartile Rangeage=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.

Paywall, https://www.seizure-journal.com/article/S1059-1311(22)00087-5/

 

I find it difficult to understand these abstracts so I may be missing something. The children were already diagnosed as having functional seizures yet they say it was a "prospectively matched-control study design". I thought that prospective studies were ones that looked at everyone with, say, EBV and then watched to see if those who developed seizures had certain characteristics beforehand.

If FS is a biological disease then you would expect bodily symptoms so increased somatisation scores on a questionnaire just says this is a sick child as does a lower quality of life score.

So the trial did not find any significant differences so they used an "experimental" analysis. This was a trial with negative results but that is not reflected in the conclusions.

"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."

Maybe the biggest contribution to FS is physical pathology.

 

When you literally define more somatization as having more symptoms, people with more symptoms will appear to have more somatization. One could define being smart as having more money if they feel like it, weird biases should not be a factor in science. It makes as much sense as defining criminal-driven behavior based on facial features.

And look at the playing with words: personality factors. I guess looking for personality traits gets old so they just slightly adjust the name and keep on looping around the track. Seriously, WTH is a personally factor and how is it different from a personality trait? Or any of the made-up categories they invented over the decades, like neuroticity and catastrophizing and all that nonsense?

What it means more than anything is that this assessment is bunk. If you ask sick people about their symptoms in a medical setting, they will report symptoms. It's literally what working in healthcare is all about. But that's obvious, except decades were wasted on this, so the loop must keep looping around.