1. Acceptability and effectiveness of a strategy for the communication of the diagnosis of psychogenic nonepileptic seizures
- Author
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Lindsey, Hall-Patch, Richard, Brown, Allan, House, Stephanie, Howlett, Steven, Kemp, Gemma, Lawton, Rebecca, Mayor, Phil, Smith, Markus, Reuber, and Martin, Zeidler
- Subjects
Adult ,Male ,medicine.medical_specialty ,Package insert ,Adolescent ,media_common.quotation_subject ,MEDLINE ,Models, Psychological ,Interviews as Topic ,Epilepsy ,Seizures ,Perception ,Surveys and Questionnaires ,medicine ,Psychogenic disease ,Humans ,Prospective cohort study ,Psychiatry ,Referral and Consultation ,media_common ,Aged ,Netherlands ,Physician-Patient Relations ,business.industry ,Communication ,Middle Aged ,medicine.disease ,Telephone interview ,Neurology ,Female ,Neurology (clinical) ,Attribution ,business ,Attitude to Health ,Follow-Up Studies - Abstract
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.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).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 (p0.001). After 3 months, 14% of patients were seizure-free and 63% reported a50% reduction in seizure frequency.We conclude that our procedure is acceptable and effectively communicates a psychological etiologic model for PNES.
- Published
- 2009