Acceptability and effectiveness of a strategy for the communication of the diagnosis of psychogenic nonepileptic seizures
Lindsey Hall-Patch, Richard Brown, Allan House, Stephanie Howlett, Steven Kemp, Gemma Lawton, Rebecca Mayor, Phil Smith, Markus Reuber, NEST collaborators, Naghme Adab, Jane Adcock, Steven Allder, Holger Allroggen, Jonathan Bird, Peter Clough, Hannah Cock, Paul Cooper, Gary Dennis, Peter Goulding, Richard Grünewald, Yvonne Hart, Steven Howell, Mark Manford, Tony Marson, Piers Newman, Andrew Nicholson, Fiona Pattison, Martin Sadler, David Smith, Tim von Oertzen, Martin Zeidler, Lindsey Hall-Patch, Richard Brown, Allan House, Stephanie Howlett, Steven Kemp, Gemma Lawton, Rebecca Mayor, Phil Smith, Markus Reuber, NEST collaborators, Naghme Adab, Jane Adcock, Steven Allder, Holger Allroggen, Jonathan Bird, Peter Clough, Hannah Cock, Paul Cooper, Gary Dennis, Peter Goulding, Richard Grünewald, Yvonne Hart, Steven Howell, Mark Manford, Tony Marson, Piers Newman, Andrew Nicholson, Fiona Pattison, Martin Sadler, David Smith, Tim von Oertzen, Martin Zeidler
Abstract
Purpose: Communicating the diagnosis of psychogenic nonepileptic seizures (PNES) is a challenging task. This study was carried out to assess the acceptability and effectiveness of a new communication procedure consisting of a patient information leaflet and a communication strategy for neurologists.
Methods: In a multicenter prospective study, 50 patients newly diagnosed with PNES were informed about the diagnosis by 10 different neurologists using the communication procedure. Follow-up data were gathered by telephone interview and completion of a questionnaire about symptom attributions (psychological/physical) and illness cognitions (Illness Perception Questionnaire-Revised, IPQ-R).
Results: Ninety-four percent of patients found the leaflet easy to understand. Ninety-four percent stated their questions were answered by the doctor; 70% got what they wanted from the consultation; only 4% reported feeling angry during the consultation. Eighty-six percent of patients acknowledged that psychological factors were at least contributing to their seizures. On the IPQ-R, "emotional" causes for the seizures were endorsed more commonly than "nonemotional" causes (p < 0.001). After 3 months, 14% of patients were seizure-free and 63% reported a >50% reduction in seizure frequency.
Discussion: We conclude that our procedure is acceptable and effectively communicates a psychological etiologic model for PNES.
Source: PubMed