Psychogenic nonepileptic seizures: Namibian healthcare providers' perceptions and frustrations

Seizure. 2017 Aug;50:43-52. doi: 10.1016/j.seizure.2017.06.004. Epub 2017 Jun 9.


Purpose: Most studies conducted on the diagnosis and treatment of psychogenic nonepileptic seizures (PNES) have been performed in developed countries with developing countries, such as Namibia, receiving less attention. This study aimed to contribute to the aims of The International League against Epilepsy Psychogenic Nonepileptic Seizure Task Force by investigating the perceptions and frustrations of healthcare providers (HCPs) in Namibia regarding the diagnosis and treatment of psychogenic nonepileptic seizures.

Methods: Semi-structured interviews were conducted with fifteen HCPs from the private healthcare sector in Namibia. Thematic analysis was used to analyse the semi-structured interviews in order to identify themes and subthemes within the data.

Results: Main themes centred on the areas of diagnosis, treatment, patients and awareness. It was found that HCPs' perceptions and frustrations were often related to the lack of knowledge and awareness regarding the disorder. Furthermore, the lack of access to specialized services and equipment contributed to HCPs' frustrations. Delays in the diagnosis of PNES added to HCPs' concerns regarding ineffective referral practices and the subsequent increase in healthcare costs. Although HCPs expressed the need for adequate training opportunities and increased awareness concerning the disorder, the lack of such opportunities and awareness campaigns were identified as possible problem areas.

Conclusions: It was evident from the findings that there are several gaps in how PNES are diagnosed and treated in Namibia. The unique challenges faced by a developing country such as Namibia were evident in some of the subthemes that highlighted the cultural differences in how PNES are conceptualized and treated.

Keywords: Diagnosis; Healthcare providers; Namibia; Psychogenic nonepileptic seizures; Qualitative; Treatment.

MeSH terms

  • Adult
  • Attitude of Health Personnel*
  • Clinical Competence
  • Conversion Disorder / diagnosis*
  • Conversion Disorder / therapy
  • Female
  • Health Personnel / psychology
  • Health Personnel / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Namibia
  • Seizures / diagnosis*
  • Seizures / therapy
  • Surveys and Questionnaires