M. Al Marzooqi, Suad
(2001)
Psychologically derived non-epileptic attack disorder (PNEAD) : psychosocial influences and psychosocial effects.
PhD thesis, University of Liverpool.
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Abstract
Some of the most pressing problems of health care involve the presentation of physical pathology in the absence of physical disease. Psychogenic non-epileptic attack disorder (PNEAD) accounts for a small but significant proportion of referrals to neurologists. Management of this condition is difficult because little is known about what factors are important in understanding its development and maintenance. Mismanagement of PNEAD can result in inappropriate use of anti-epileptic drugs and neglect of psychological needs. This thesis contains 3 studies. Study 1 examined the psychosocial factors that are important in understanding the development and maintenance of PNEAD. Assessments included childhood and adulthood abuse, anxiety and depression, somatisation, parental overprotection, hypochondriacal concerns and family dysfunction. One hundred and sixty two patients took part in this study matched for age and sex between PNEAD and epilepsy groups. PNEAD patients recalled more childhood and adulthood abuse than epilepsy patients and were more emotionally distressed. Findings from this study suggest that abuse and family of origin are involved in the development ofPNEAD. In study 2, 30 patients with PNEAD were matched by age and gender with an epilepsy control group. They completed questionnaires at the time of diagnosis and 3 months later measuring impact of condition, illness and symptom beliefs, family and psychosocial functioning, and satisfaction with consultation. This study compared PNEAD and epilepsy patients' reaction to the diagnosis of their condition.Before diagnosis there were few significant differences between PNEAD and epilepsy patients. After diagnosis significant differences emerged between the two groups. The diagnosis of PNEAD patients, compared with epilepsy patients, was associated with a greater negative psychological impact. Such findings may reflect for PNEAD patients the fact that they are not provided with an adequate explanation for their symptoms and behaviour. In study 3, 194 patients were matched between PNEAD and epilepsy groups by age and gender. They had been diagnosed 12-36 months previously. This study examined factors that may contribute to differences in impact of PNEAD vs epilepsy by measuring family and psychosocial function, beliefs regarding illness, clinical characteristics of attacks and satisfaction with the consultation process. Impact of the condition was greater for PNEAD than epilepsy patients. Factors that helped to explain such differences included the perceived psychological and physical impairment.
| Item Type: | Thesis (PhD) |
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| Depositing User: | Symplectic Admin |
| Date Deposited: | 20 Oct 2023 17:55 |
| Last Modified: | 20 Oct 2023 18:24 |
| DOI: | 10.17638/03175197 |
| Copyright Statement: | Copyright © and Moral Rights for this thesis and any accompanying data (where applicable) are retained by the author and/or other copyright owners. A copy can be downloaded for personal non-commercial research or study, without prior permission or charge. |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3175197 |
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