Report on a psychoeducational intervention for psychogenic non-epileptic seizures in Argentina.

PURPOSE: To examine the effects of a three-session psychoeducational intervention on patients diagnosed with psychogenic non-epileptic seizures (PNES) in an Argentinian public hospital. It was hypothesized that patients would experience improvements in their understanding of PNES, illness perception and affective scores, but might not necessarily experience a significant change in post-traumatic and dissociative symptoms and in seizure frequency. METHODS: This study included 12 patients (10 women, 2 men) who were invited to participate in a psychoeducational group after receiving a V-EEG confirmed diagnosis of PNES. The group consisted of 3 sessions lasting 2 h each. Pre and post measures included Psychoeducational Intervention Questionnaire, State-Trait Anxiety Inventory, Beck Depression Inventory-II, Brief Illness Perception Questionnaire, Posttraumatic Stress Disorder Diagnostic Scale 5, Dissociative Experiences Scale (DES-M). RESULTS: This psychoeducational intervention produced results that were similar to interventions reported in US and European studies with regard to changes on psychological measures. Moreover, many patients also reported (on the final day of the intervention) a decrease in seizure frequency. All patients reported that participating in the intervention was a positive experience. Also, all but one patient referred that the participation in the group would have a positive impact on their quality of life. CONCLUSIONS: Psychoeducational interventions appear to have had positive results in Argentinian patients with PNES. This is initial step in the design of empirically based psychoeducational/supportive initiatives for patients in South America.

Long-term outcome in a sample of underprivileged patients with psychogenic nonepileptic seizures (PNES) living in Argentina.

OBJECTIVE: The objective of the present study was to perform a long-term follow-up of economically disadvantaged Latin American patients diagnosed as having psychogenic nonepileptic seizures (PNES) and contribute to the field's understanding of outcome in this population. BACKGROUND: A handful of studies have examined outcome of patients once the diagnosis of PNES has been communicated. However, the vast majority of these have been conducted in the first world countries with samples that were predominantly Caucasian. There is limited knowledge about outcome in economically disadvantaged Latin American patients diagnosed as having PNES. METHODS: This is a study of 23 patients (20 women, 3 men) with PNES in which demographic data (age, education, nationality, presence of psychological trauma, age of onset) were retrospectively retrieved from medical files. Follow-up was done through a telephonic questionnaire in which investigators collected clinical information (seizure characteristics at follow-up, and treatments employed) and changes in demographic data. RESULTS: Patients from this Argentinian PNES sample demonstrated having many similar demographic and clinical characteristics to samples from US and European studies. Long-term follow-up revealed, however, decreased seizure frequency and intensity as well as a substantial improvement in occupational status. A majority had engaged in psychotherapy as well as alternative and complementary approaches. A majority had also developed what are suspected to be other functional symptoms. CONCLUSIONS: Argentinian patients from economically disadvantaged backgrounds, diagnosed as having PNES reported improvements in seizure frequency and occupational status during long-term follow-up. Future studies will need to focus on what (e.g., communication of diagnosis, psychotherapy, alternative treatments) may have contributed to these changes.

What patients think about psychogenic nonepileptic seizures in Buenos Aires, Argentina: A qualitative approach.

PURPOSE: To analyse the methods of reasoning with regard to patients' experiences of living with psychogenic nonepileptic seizures (PNES) in Buenos Aires, Argentina. METHOD: A qualitative approach using semi-structured interviews was used to gain an in-depth and contextual understanding of the perspectives of five patients with PNES. Data collection and analysis were followed by an inductive and interpretive approach informed by the principles of thematic analysis. RESULTS: Explanatory models and prototypes were identified from the patients' narratives. Four patients related their suffering regarding psychosocial causes -family conflicts, sexual harassment, and life changes, among others-. Hereditary and organic hypotheses appeared to be unspecific. Folk explanations were common to all participants (magic, witchcraft, energetic causes). Four patients used the term epilepsy as an illness prototype, focusing on seizures and the use of antiepileptic drugs. Three of them also compared their illness to other people's "attacks" (heart attacks, panic attacks, nervous breakdown). Only one of them referred to someone who was suspected of having epilepsy. CONCLUSION: Patients' psychosocial explanatory models are different from the results of previous studies because these studies indicate that most patients support somatic explanations. Patients also use folk explanations related to traditional medicine, which highlights the interpersonal aspects of the disease. Doctor-patient communication is essential for a correct understanding of PNES, resulting in better outcomes. It could also help to reduce the cultural distance between professionals and patients, leading to narrowing inequalities present in multicultural healthcare services.