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

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

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Academic Unit of Psychiatry and Behavioural Sciences, University of Leeds, Leeds, United Kingdom.



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.


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).


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.


We conclude that our procedure is acceptable and effectively communicates a psychological etiologic model for PNES.

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