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Severe Caregiver Distress Precipitating Dissociative Seizures in a Patient with Intellectual Disability and Epilepsy: Diagnostic and Therapeutic Hardships

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Abstract

Comorbid psychiatric diagnoses increase the caregiver burden in patients with intellectual disability (ID). There is scarce literature on the dynamics between caregiver distress and psychopathology in persons with ID, especially regarding the dissociative disorders. We present the case of a young female with cerebral palsy, ID, epilepsy and psychosis where conflict with caregivers due to their emotional over-involvement precipitated dissociative seizures. We performed Antecedent-Behavior-Consequence (ABC) analysis which helped in identifying negative expressed emotions in the caregivers. An integrated psychosocial intervention brought significant reduction in the dissociation which facilitated the overall therapeutic process. Adverse emotional turmoil due to expressed emotions from caregivers can precipitate dissociative events in patients with ID. Dissociative seizures in a patient with ID and epilepsy may pose diagnostic challenges and can hamper therapeutic response which can be overcome by behavior analyses and integrated psychosocial interventions.

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Authors and Affiliations

  1. Department of Psychiatry, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Dhanvanthri Nagar, Puducherry, 605006, India

    Pravallika Madhavapuri, Karthick Subramanian & Preeti Kandasamy

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  1. Pravallika Madhavapuri
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  2. Karthick Subramanian
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  3. Preeti Kandasamy
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Correspondence to Karthick Subramanian.

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The authors declare that they do not have any conflict of interest.

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Informed consent was obtained from the legally represented caretaker of the patient (since the patient had intellectual disability, the consent was obtained from the guardian).

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Madhavapuri, P., Subramanian, K. & Kandasamy, P. Severe Caregiver Distress Precipitating Dissociative Seizures in a Patient with Intellectual Disability and Epilepsy: Diagnostic and Therapeutic Hardships. J. Psychosoc. Rehabil. Ment. Health 3, 113–115 (2016). https://doi.org/10.1007/s40737-016-0060-y

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  • DOI: https://doi.org/10.1007/s40737-016-0060-y

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