Primary care and emergency physician attitudes and beliefs related to patients with psychogenic nonepileptic spells

Abstract

Psychogenic nonepileptic spells (PNES) are typically evaluated by primary care and emergency physicians before neurologists. The attitudes and beliefs of such physicians about PNES may impact long-term outcomes and quality of care for these challenging patients. A 21-question survey was created to assess knowledge of, beliefs about, and attitudes toward the diagnosis and management of PNES. The survey found misperceptions that PNES are voluntary, that video/EEG monitoring is not needed to confirm the diagnosis of PNES, and that clinical history is sufficient for diagnosis. Ninety-five percent believe that counseling and psychotherapy are the most appropriate therapies. Ongoing education and outreach to referring physicians about PNES are indicated, especially because early diagnosis of PNES has been associated with better outcomes.