Opinion survey of health care providers towards psychogenic non epileptic seizures

Sahaya, Kinshuk; Dholakia, Swapan; Lardizabal, David; Sahota, Pradeep

doi:10.1016/j.clineuro.2012.03.047

Cited by 32 publications

(31 citation statements)

References 20 publications

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“…Uncertainty was a recurrent concept. Perhaps not surprisingly, more highly specialized clinicians (ie, neurologists) tended to report greater exposure to PNES and feeling more “confident” about managing the condition than those less specialized, such as physicians in family, internal, or general medicine …”

Section: Resultsmentioning

confidence: 99%

“…Uncertainty about labeling is implicit in many different terms being in use. The majority of HCPs seemed to prefer etiologically neutral terms, specifically, “nonepileptic seizures,” “nonepileptic attacks,” or “nonepileptic attack disorder.” Rather than saying anything about the putative mechanism causing the seizures, these nonspecific diagnostic labels state what the patient does not have. Other terms such as “psychogenic nonepileptic seizures” were less common .…”

Section: Resultsmentioning

confidence: 99%

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Health care practitioners’ perceptions of psychogenic nonepileptic seizures: A systematic review of qualitative and quantitative studies

Rawlings

Reuber

2018

Epilepsia

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A recent systematic synthesis of qualitative research demonstrated that patients with psychogenic nonepileptic seizures (PNES) often experience unsatisfactory encounters with health care practitioners (HCPs). It is important to understand such interactions from the perspective of those responsible for delivering care. This systematic review aimed to examine the attitudes and perceptions of HCPs toward PNES. A systematic search of 3 databases (Web of Science, PubMed, and CINAHL) was conducted in November 2017. Studies from around the world published after 1997 using qualitative or quantitative methodologies were reviewed. An interpretative stance was taken to analyze the data utilizing a grounded theory approach. The quality of studies included was assessed using the Mixed Methods Appraisal Tool. Overall, 30 separate studies capturing the views of at least 3900 professionals were included. Five concepts emerged from the analysis: (1) HCPs' responses demonstrated uncertainty about many aspects of PNES, including diagnosis and treatment; (2) HCPs understood PNES in dualistic terms, perceiving the condition as largely associated with psychological factors; (3) Patients with PNES were considered challenging and frustrating; (4) HCPs held mixed or contested views about who is responsible for treating patients with PNES; and (5) PNES was viewed as less severe or disabling than epilepsy and associated with a greater degree of volition. Although some HCPs have an excellent understanding of PNES, the views of many give rise to concern. The number of qualitative studies that directly ask HCPs about their perceptions of PNES is limited. Moreover, some professional groups (ie, mental health specialists) are underrepresented in current research. This study reveals a demand for additional training. However, effort is needed also to change the attitudes of some practitioners toward PNES.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Health care practitioners’ perceptions of psychogenic nonepileptic seizures: A systematic review of qualitative and quantitative studies

Rawlings

Reuber

2018

Epilepsia

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“…34 This is again reflected in this survey, where 82.5% of GPs reported that psychiatry should play a role in the management of these patients. 12 This finding was more common among younger compared to older GPs, and may reflect a simple lack of experience. The consensus document highlights a need for "doctors" to play a role in "treatment maintenance" in a proportion of patients but does not specify the nature of these doctors.…”

Section: Discussionmentioning

confidence: 98%

“…The role of neurologists in the management of patients with functional seizures is less clear. 12,13 Neurologists, rather than GPs or psychiatrists, may indeed be well placed to take on this role of "treatment maintenance" for both practical and medical reasons. Although half of the GP respondents in this survey expressed a moderate or high interest in managing these patients, a similar proportion reported feeling unconfident or very unconfident in managing them and dealing with their queries.…”

Section: Discussionmentioning

confidence: 99%

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Functional seizures: An evaluation of the attitudes of general practitioners local to a tertiary neuroscience service in London

et al. 2018

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Summary Objective Functional seizures are a common functional neurologic disorder. Given their chronic nature, and the biopsychosocial factors involved in their etiology, general practitioners (GPs) play a crucial role in the care of these patients. However, little is known about the attitudes of GPs toward, and knowledge of, functional seizures. Methods The Atkinson Morley Regional Neuroscience Centre in London provides a comprehensive service to patients with functional seizures. As part of a service evaluation we conducted an online survey among local GPs over a 1‐month period assessing their attitudes toward, and knowledge of, functional seizures. Results One hundred twenty of 974 surveyed GPs replied to the survey (12.3%). Approximately 75% of GPs readily use the term “pseudoseizures,” and over 50% were not sure or did not think that functional seizures were involuntary. Nearly 30% believed, or were unsure as to whether, functional seizures occur only when patients are stressed. Despite approximately 50% of GPs expressing interest in getting involved in the management of these patients, a similar proportion do not feel confident in dealing with queries from patients with functional seizures. Although most GPs felt that neurology and psychiatry should be the primary caregivers in the diagnosis and management, respectively, of functional seizures, 50% were also of the opinion that neurology should be involved in the management of these patients. Significance This survey highlights the attitudes of, and descriptive terms used by, GPs toward patients with functional seizures. Our findings suggest a need for better and clearer provision of information to GPs about this condition.

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Driving a motor vehicle and psychogenic nonepileptic seizures: ILAE Report by the Task Force on Psychogenic Nonepileptic Seizures

et al. 2020

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Objectives This International League Against Epilepsy (ILAE) Report: (a) summarizes the literature about “driving and psychogenic nonepileptic seizures (PNES)”; (b) presents the views of international experts; and (c) proposes an approach to assessing the ability of persons with PNES (PwPNES) to drive. Methods Phase 1: Systematic literature review. Phase 2: Collection of international expert opinion using SurveyMonkey®. Experts included the members of the ILAE PNES Task Force and individuals with relevant publications since 2000. Phase 3: Joint analysis of the findings and refinement of conclusions by all participants using email. As an ILAE Report, the resulting text was reviewed by the Psychiatry Commission, the ILAE Task Force on Driving Guidelines, and Executive Committee. Results Eight studies identified by the systematic review process failed to provide a firm evidence base for PNES‐related driving regulations, but suggest that most health professionals think restrictions are appropriate. Twenty‐six experts responded to the survey. Most held the view that decisions about driving privileges should consider individual patient and PNES characteristics and take account of whether permits are sought for private or commercial driving. Most felt that those with active PNES should not be allowed to drive unless certain criteria were met and that PNES should be thought of as “active” if the last psychogenic seizure had occurred within 6 months. Significance Recommendations on whether PwPNES can drive should be made at the individual patient level. Until future research has determined the risk of accidents in PwPNES a proposed algorithm may guide decisions about driving advice.

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Opinion survey of health care providers towards psychogenic non epileptic seizures

Cited by 32 publications

References 20 publications

Health care practitioners’ perceptions of psychogenic nonepileptic seizures: A systematic review of qualitative and quantitative studies

Health care practitioners’ perceptions of psychogenic nonepileptic seizures: A systematic review of qualitative and quantitative studies

Functional seizures: An evaluation of the attitudes of general practitioners local to a tertiary neuroscience service in London

Driving a motor vehicle and psychogenic nonepileptic seizures: ILAE Report by the Task Force on Psychogenic Nonepileptic Seizures

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