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Asadi-Pooya AA, Brigo F, Trinka E, Lattanzi S, Adel Kishk N, Karakis I, Ristic AJ, Alsaadi T, Alkhaldi M, Turuspekova ST, Aljandeel G, Al-Asmi A, Contreras G, Daza-Restrepo A, Kutlubaev MA, Guekht A, Calle-López Y, Jusupova A, San-Juan D, Khachatryan SG, Gigineishvili D, Mesraoua B, Dubenko A, Mirzaei Damabi N. A global survey on the attitudes of neurologists and psychiatrists about functional/psychogenic/dissociative/nonepileptic-seizures/attacks, in the search of its name. Epilepsy Behav 2023; 145:109292. [PMID: 37321160 DOI: 10.1016/j.yebeh.2023.109292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 05/26/2023] [Accepted: 05/27/2023] [Indexed: 06/17/2023]
Abstract
PURPOSE We conducted an observational study to investigate the opinions of neurologists and psychiatrists all around the world who are taking care of patients with seizures [epilepsy and functional seizures (FS)]. METHODS Practicing neurologists and psychiatrists from around the world were invited to participate in an online survey. On 29th September 2022, an e-mail including a questionnaire was sent to the members of the International Research in Epilepsy (IR-Epil) Consortium. The study was closed on 1st March 2023. The survey, conducted in English, included questions about physicians' opinions about FS and anonymously collected data. RESULTS In total, 1003 physicians from different regions of the world participated in the study. Both neurologists and psychiatrists identified "seizures" as their preferred term. Overall, the most preferred modifiers for "seizures" were "psychogenic" followed by "functional" by both groups. Most participants (57.9%) considered FS more difficult to treat compared to epilepsy. Both psychological and biological problems were considered as the underlying cause of FS by 61% of the respondents. Psychotherapy was considered the first treatment option for patients with FS (79.9%). CONCLUSION Our study represents the first large-scale attempt of investigating physicianś attitudes and opinions about a condition that is both frequent and clinically important. It shows that there is a broad spectrum of terms used by physicians to refer to FS. It also suggests that the biopsychosocial model has gained its status as a widely used framework to interpret and inform clinical practice on the management of patients.
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Affiliation(s)
- Ali A Asadi-Pooya
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA.
| | - Francesco Brigo
- Department of Neurology, Hospital of Merano (SABES-ASDAA), Merano-Meran, Italy; Lehrkrankenhaus der Paracelsus Medizinischen Privatuniversität, Salzburg, Austria.
| | - Eugen Trinka
- Department of Neurology, Christian-Doppler Medical Centre, Paracelsus Medical University, 5020 Salzburg, Austria; Institute Neuroscience Christian-Doppler Medical Centre, Paracelsus Medical University, Austria; Centre for Cognitive Neuroscience, 5020 Salzburg, Austria; Member of the European Referencenetwork EpiCARE, European; Department of Public Health, Health Services Research and Health Technology Assessment, UMIT - University for Health Sciences, Medical Informatics and Technology,Hall in Tirol, Austria.
| | - Simona Lattanzi
- Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy.
| | - Nirmeen Adel Kishk
- Department of Neurology, Cairo University Epilepsy Unit (CUEU), School of Medicine, Cairo University, Cairo, Egypt.
| | - Ioannis Karakis
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.
| | - Aleksandar J Ristic
- Clinic for Neurology, Clinical Center of Serbia, Medical Faculty University of Belgrade, Serbia.
| | - Taoufik Alsaadi
- Deptartment of Neurology, American Center for Psychiatry and Neurology, and Khalifa University, Abu Dhabi, UAE.
| | - Modhi Alkhaldi
- Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, P.O Box 34212, Dammam, Saudi Arabia.
| | - Saule T Turuspekova
- Department of Nervous Diseases, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan.
| | - Ghaieb Aljandeel
- Iraqi Council for Medical Specializations, Faculty of Epileptology, Medical City, Baghdad, Iraq.
| | - Abdullah Al-Asmi
- Neurology Unit, Department of Medicine, College of Medicine and Health Sciences and Sultan Qaboos University Hospital, Sultan Qaboos University, Oman.
| | | | - Anilu Daza-Restrepo
- Neurosciences and Complex Systems Unit (ENyS), Epilepsy Unit, CONICET, Hosp. El Cruce "N. Kirchner", Univ. Nat. A. Jauretche (UNAJ), F. Varela, Prov. Buenos Aires, Argentina.
| | - Mansur A Kutlubaev
- Department of Neurology, Bashkir State Medical University, Ufa., Russia.
| | - Alla Guekht
- Moscow Research and Clinical Center for Neuropsychiatry, Department of Neurology, Nerosurgery and Medical Genetics, Pirogov Russian National Research Medical University, Moscow, Russia.
| | - Yamile Calle-López
- Facultad de Medicina, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia; Hospital Universitario San Vicente Fundación, Medellín, Colombia.
| | - Asel Jusupova
- Kyrgyz State Medical Academy, Neurology and Clinical Genetics Department, Bishkek, Kyrgyzstan.
| | - Daniel San-Juan
- Epilepsy Clínic. National Institute of Neurology and Neurosurgery, México City, Mexico.
| | - Samson G Khachatryan
- Department of Neurology and Neurosurgery, National Institute of Health, Yerevan, Armenia.
| | - David Gigineishvili
- Institute of Neurology, Javakhishvili Tbilisi State University, Department of Neurology & Neurosurgery, Tbilisi, Georgia.
| | - Boulenouar Mesraoua
- Neurosciences Department, Hamad Medical Corporation and Weill Cornell Medical College, Doha, Qatar.
| | - Andriy Dubenko
- Institute of Neurology, Psychiatry and Narcology of NAMS, Ukraine.
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Terminology for psychogenic nonepileptic seizures: Making the case for "functional seizures". Epilepsy Behav 2020; 104:106895. [PMID: 31986440 DOI: 10.1016/j.yebeh.2019.106895] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 12/28/2019] [Accepted: 12/29/2019] [Indexed: 01/28/2023]
Abstract
PURPOSE The purpose of the study was to review the literature on the terminologies for psychogenic nonepileptic seizures (PNES) and make a proposal on the terminology of this condition. This proposal reflects the authors' own opinions. METHODS We systematically searched MEDLINE (accessed from PubMed) and EMBASE from inception to October 10, 2019 for articles written in English with a main focus on PNES (with or without discussion of other functional neurological disorders) and which either proposed or discussed the accuracy or appropriateness of PNES terminologies. RESULTS The search strategy reported above yielded 757 articles; 30 articles were eventually included, which were generally of low quality. "Functional seizures" (FS) appeared to be an acceptable terminology to name this condition from the perspective of patients. In addition, FS is a term that is relatively popular with clinicians. CONCLUSION From the available evidence, FS meets more of the criteria proposed for an acceptable label than other popular terms in the field. While the term FS is neutral with regard to etiology and pathology (particularly regarding whether psychological or not), other terms such as "dissociative", "conversion", or "psychogenic" seizures are not. In addition, FS can potentially facilitate multidisciplinary (physical and psychological) management more than other terms. Adopting a universally accepted terminology to describe this disorder could standardize our approach to the illness and facilitate communication between healthcare professionals, patients, their families, carers, and the wider public.
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