Providers' perspectives on treating psychogenic nonepileptic seizures: frustration and hope

Epilepsy Behav. 2014 Aug;37:276-81. doi: 10.1016/j.yebeh.2014.07.001. Epub 2014 Aug 13.


Recent diagnostic and treatment advances in psychogenic nonepileptic seizures (PNES) have the potential to improve care for patients, but little is known about the current state of PNES care delivery in the Veterans Health Administration (VA). We conducted semistructured interviews with 74 health-care clinicians and workers in the VA, eliciting provider perceptions of PNES care. Data were analyzed according to principles of Grounded Theory. The results revealed variation in care and two emergent domain themes of frustration and hope. Frustration was manifest in subthemes including Complexity, Patient Acceptance, Uncertainty About Treatment, Need for Evidence-based Treatment, and Failure of Cross-Disciplinary Collaboration between neurologists and mental health providers. Hope encompassed subthemes of Positive Attitudes, Developing Cross-Disciplinary Treatment, and Specific PNES Care. Increased resources for diagnosing, treating, and researching PNES have improved awareness of the disorder. More research is needed to understand patients' and caregivers' perceptions of PNES care.

Keywords: Cognitive behavioral therapy; Diagnosis; Nonepileptic seizures; Practitioners; Treatment; Veterans.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Attitude of Health Personnel*
  • Cognitive Behavioral Therapy / methods*
  • Comprehension
  • Electroencephalography
  • Frustration*
  • Health Knowledge, Attitudes, Practice
  • Health Services Needs and Demand
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care / statistics & numerical data
  • Perception
  • Qualitative Research
  • Seizures / diagnosis
  • Seizures / psychology
  • Seizures / therapy*
  • United States
  • United States Department of Veterans Affairs