Diagnostic and treatment services for patients with Psychogenic Nonepileptic Seizures (PNES): A survey of health professionals in urban China

Seizure. 2018 Mar:56:78-87. doi: 10.1016/j.seizure.2018.01.017. Epub 2018 Jan 31.


Purpose: This study is intended to provide an overview of diagnostic and treatment services for patients with psychogenic nonepileptic seizures (PNES) across China.

Methods: Using a questionnaire devised by the PNES Task Force of Neuropsychiatry Commission of the International League Against Epilepsy (ILAE), we conducted a survey among Chinese health professionals at the Sixth Advanced International Course: Clinical Epileptology. Descriptive analyses were performed.

Results: Responses from 102 eligible clinicians were analysed. Responses were received from urban areas in 20 provinces/municipalities around China. Most respondents were neurologists. The results showed that hospitals in urban China were mostly well-equipped, and that health professionals' understanding of PNES largely reflected current international expert opinion. However, many of the participants would not actually make the diagnosis, and most provided neither follow-up nor treatment (especially psychotherapy) for patients with PNES. Only about one third of the patients diagnosed with PNES were estimated to receive at least one appointment for psychological treatment. In the opinion of the respondents, tacit trauma (neglect and stress) play an important role in the development of PNES. The main obstacles to patients with PNES accessing health services for their condition were thought to be lack of knowledge or awareness among health professionals, patients and society.

Conclusion: Despite good access to equipment, diagnostic and treatment services for patients with PNES in China are currently deficient. Education programs about PNES with different target groups, and more effective referral and social security systems emerge as particular development needs from this survey.

Keywords: China; Diagnosis; Health service; Neurologist; Psychogenic Nonepileptic Seizures; Survey; Treatment.

MeSH terms

  • Adult
  • China
  • Disease Management*
  • Female
  • Health Occupations*
  • Health Surveys
  • Humans
  • Male
  • Middle Aged
  • Psychophysiologic Disorders / complications
  • Psychophysiologic Disorders / diagnosis*
  • Psychophysiologic Disorders / epidemiology
  • Psychophysiologic Disorders / therapy*
  • Seizures / diagnosis*
  • Seizures / epidemiology
  • Seizures / therapy*
  • Surveys and Questionnaires
  • Urban Population
  • Young Adult