Psychological Factors associated with Somatisation and Seizure Frequency in Seizure Conditions: Comparing Intolerance of Uncertainty, Anxiety Sensitivity, Anxiety, and Depression between People with Epilepsy and Dissociative Seizures

Paper 1 is a literature review of 7 databases, exploring 17 studies investigating intolerance of uncertainty (IU) as a potential predictor of post-traumatic stress symptoms in community populations (PTSS). A modified AXIS critical appraisal tool was used, followed by narrative synthesis. Included papers were of good quality. Results suggested that IU was consistently correlated with PTSS, significantly predicting higher PTSS scores in nine out of 12 cross-sectional survey studies and two out of five prospective survey studies. Findings suggested that more research, particularly with longitudinal designs, across different populations would be beneficial, whilst tentatively suggesting that therapeutic interventions targeting IU may be of benefit for people with PTSS.

Paper 2 is a cross-sectional, observational, study investigating psychological factors in 90 participants with a diagnosis of epilepsy (n=44) or dissociative seizures (n=46). The study involved completing online measures of IU, anxiety sensitivity (AS), anxiety, depression, and somatisation. Participants also completed a questionnaire about demographic information and seizure condition factors, such as seizure frequency. Scores on all measures were higher for people with dissociative seizures but not to a statistically significant extent. Multiple regression analysis investigated whether IU, AS, anxiety, depression, or diagnosis of seizure condition predicted somatisation or seizure frequency. Only depression predicted somatisation and no variables predicted seizure frequency. The study found high means for intolerance of uncertainty and anxiety sensitivity, and moderate levels of anxiety, depression, and somatisation in participants with epilepsy and dissociative seizures. Findings suggest that for people with seizure conditions experiencing somatisation, interventions targeting depression could be most impactful, relative to other variables in this study. A key limitation was the collection and analysis of seizure frequency data, reflective of broader issues in the literature.

Paper 3 is an executive summary of paper two, designed for service users and the people supporting them.