Acceptability and effectiveness of a strategy for the communication of the diagnosis of psychogenic nonepileptic seizures.
OBJECTIVE
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.


CONCLUSIONS
We conclude that our procedure is acceptable and effectively communicates a psychological etiologic model for PNES.
Hall-Patch
Lindsey
L
Academic Unit of Psychiatry and Behavioural Sciences, University of Leeds, Leeds, United Kingdom.
Brown
Richard
R
House
Allan
A
Howlett
Stephanie
S
Kemp
Steven
S
Lawton
Gemma
G
Mayor
Rebecca
R
Smith
Phil
P
Reuber
Markus
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D003142:Communication; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D009426:Netherlands / Q000453:epidemiology; D009462:Neurology / Q000379:methods*; D010817:Physician-Patient Relations; D012017:Referral and Consultation; D012640:Seizures / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D011795:Surveys and Questionnaires