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

Epilepsia. 2010 Jan;51(1):70-8. doi: 10.1111/j.1528-1167.2009.02099.x. Epub 2009 Apr 27.


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.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Attitude to Health*
  • Communication*
  • Female
  • Follow-Up Studies
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Models, Psychological
  • Netherlands / epidemiology
  • Neurology / methods*
  • Physician-Patient Relations*
  • Referral and Consultation
  • Seizures / diagnosis*
  • Seizures / epidemiology
  • Seizures / psychology
  • Surveys and Questionnaires*