This study provides evidence that almost any treatment will have some efficacy with this difficult group of patients. Weekly phone calls appeared particularly helpful. These findings corroborate the efficacy of cognitive behavior therapy and SSRIs.
I am not certain that the psychiatry consultation needs to occur in the inpatient setting, and this is often difficult to obtain in the “real world.” Outpatient psychiatry and psychology consultations should be sufficient. However, one of the biggest challenges in the management of patients with psychogenic nonepileptic seizures once the diagnosis is made is to find interested and cooperative mental health professionals who believe the diagnosis.1,2 Unfortunately, many mental health professionals simply do not believe the diagnosis, or they are not interested in providing treatment to this population. Sadly, this is consistent with the stance of our mental health organizations, which generally show little interest in this category of disorders. In fact, illustratively, neither the American Psychiatric Association nor the American Psychological Association provides any patient information materials on this category of disease.2,3 As a result, these patients typically find themselves caught “in the middle” between the neurologist and the psychiatrist.
—Selim R. Benbadis, MD
Professor and Director
Comprehensive Epilepsy Program
University of South Florida and Tampa General Hospital
Professor and Director
Comprehensive Epilepsy Program
University of South Florida and Tampa General Hospital
To read the main article, click here.