Preliminary Report of Psychogenic Non-Epileptic Seizure Diagnosis Among Veterans From 2004–2014 (P6.275)

Objective: Describe the change in the number Veterans diagnosed with psychogenic non-epileptic seizures (PNES) in the Department of Veterans Affairs (VA). Background: Of the nearly 1 million veterans who served in Operations Iraqi Freedom, Enduring Freedom, and New Dawn (OIF/OEF/OND) who received care between 2004–2014, approximately 4000 were diagnosed with a seizure disorder based on VA diagnostic coding. Many veterans who carry the diagnosis of epilepsy suffer from PNES and require dedicated mental health services. Many veterans with PNES suffer from post traumatic stress disorder, traumatic brain injury, and delay in care. Our retrospective cohort study will explore risk factors and protective factors, utilization of services, barriers to services, and outcomes of veterans with newly diagnosed PNES. Here we report our preliminary findings of cumulative prevalence of OIF/OEF/OND veterans with PNES from 2004–2014. Design/Methods: We used data from the Women Veteran Cohort Study (N=985,750) to identify Veterans in VA care with epilepsy or other seizure disorder diagnosis (ICD-9 code of 345 or 780.39) from 2004 to 2014. Since there is no ICD-9 code to identify Veterans with PNES in the VA national database and the ICD-9 code for conversion disorder (300.11) has not been readily used by neurologists to label PNES, we used an electronic health record informatics text tool called Voogo to identify patients with PNES as documented in neurologists’ progress notes and described elsewhere. Cumulative prevalence of PNES per 1000 Post 9/11 was calculated yearly from 2004–2014. Results: The cumulative prevalence of PNES in the VA system is increased from 0.0727 to 0.3662 per 1000 OIF/OEF/OND Veterans (a 122.7% increase) from 2004 to 2014. Conclusions: The number of PNES cases identified steadily increased each year from 2004–2014 and the burden of PNES in the VA healthcare system has doubled during that decade. Study Supported by: This work was supported by the Office of the Assistant Secretary of Defense for Health Affairs through the Epilepsy Research Program under Award No. EP160049 (HA) as well as a Veteran Health Administration Health Services Research and Development Center of Innovation Award CIN 12-118 u0026 13-047 (CB). Disclosure: Dr. Khan has nothing to disclose. Dr. Proops has nothing to disclose. Dr. Flaherty has nothing to disclose. Dr. Fenton has nothing to disclose. Dr. Pugh has nothing to disclose. Dr. Cheung has nothing to disclose. Dr. Goulet has nothing to disclose. Dr. Brandt has nothing to disclose. Dr. Altalib has nothing to disclose.