Perceptions of Psychogenic Pseudoseizures Differentiated between Neurologists and Psychiatrists
Abstract number :
2.112
Submission category :
Year :
2001
Submission ID :
3030
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
L. Ponticello, RN, Neurology, Weill Medical Center at Cornell University, New York, NY; A.M. Kanner, MD, Neurology, Rush Presbyterian Medical College, Chicago, IL; B.G. Nikolov, MD, Neurology, Weill Medical Center at Cornell University, New York, NY; C.L.
RATIONALE: It is the perception that neurologists and psychiatrists often misunderstand each other when caring for patients with psychogenic pseudoseizures, and it is of concern that this misunderstanding may negatively impact patient care. We performed a questionnaire to determine if psychiatrists and neurologists view aspects of psychogenic pseudoseizure patient care differently, in order to increase understanding between the disciplines.
METHODS: At an interdisciplinary conference for psychiatrists and neurologists, participants were asked to complete an anonymous questionnaire, consisting of disclosing their field of medicine and completing three more multiple choice questions as follows:
1) Patients with psychogenic pseudoseizures are accurately diagnosed using video-EEG monitoring a) Most of the time b) Some of the time c) Almost never
2) In addition to being told about their diagnosis, the best treatment for psychogenic pseudoseizure patients is a) psychotherapy b) family therapy c) hypnosis d) behavioral therapy e) depends on psychiatric diagnosis f) none g) other
3) The main reason that psychogenic pseudoseizure patients often [dsquote]fall through the cracks[dsquote] is due to a) Doctors [dsquote]dropping the ball[dsquote] b) Patients[ssquote] own psychopathology interferes with treatment c) Medical insurance issues
The results were analyzed by evaluating the different distribution in answers according to discipline using chi-square.
RESULTS: The seventy-nine respondents in terms of discipline were: 24 neurologists, 43 psychiatrists, 8 [dsquote]other[dsquote] including internists, pediatricians and social workers, and 4 neuropsychologists. There was a significant difference between disciplines in response to the first question with 13 neurologists and 6 psychiatrists answering a) and 11 neurologists and 30 psychiatrists answering b). No neurologist and 5 psychiatrists answered c) (p=0.012). Seven of the remaining 12 respondents answered b) to question 1 as well.
There was no significant difference in distribution between disciplines in answer to the other questions; the majority of respondents answered e) to question 2. In response to question 3, neurologists, more than psychiatrists, tended to think that patients themselves interfered with treatment rather than doctors [dsquote]dropping the ball[dsquote], but this difference was not significant.
CONCLUSIONS: A point of departure between neurologists and psychiatrists regarding psychogenic pseudoseizure patients is that psychiatrists often do not have confidence in the diagnostic tool used to make the diagnosis. This basic difference in ultimately believing the diagnosis could negatively impact patient care.
Support: No support