A standardized diagnostic approach and ongoing feedback improves outcome in psychogenic XXXX .

@entity1 @entity410 @entity458 @entity146
INTRODUCTION: Psychogenic @entity410 (PNES) are episodic alterations in behavior presumed to reflect a physical manifestation of underlying @entity458 . Standardized treatment approaches for PNES care are lacking. We evaluated common approaches to PNES management that do not require significant commitment of time and resources. METHODOLOGY: @entity1 with PNES established with video-EEG monitoring were randomized to one of the following three groups: 1) PNES diagnosis delivered per the discretion of the attending physician with advice to seek mental health assistance in the community (n=12), 2) scripted PNES diagnosis provided and inpatient psychiatry consult obtained (n=10), and 3) weekly follow-up phone calls made in addition to scripted diagnosis and inpatient psychiatry consultation (n=15). Reduction in event frequency measured at 8weeks following hospital discharge represented the primary outcome variable. Secondary variables analyzed included exploration of change in self-reported mood, quality of life, and healthcare utilization. RESULTS: No significant improvements were noted in @entity1 simply given a PNES diagnosis and advised to seek outside care on any measure. In contrast, @entity1 receiving a scripted diagnosis and @entity146 consultation demonstrated decreased PNES frequency accompanied by improved quality of life (QOL). @entity1 also receiving weekly phone calls not only demonstrated decreased PNES frequency and improvements in QOL but also exhibited improved mood. DISCUSSION: These findings demonstrate that providing diagnostic information regarding PNES is insufficient by itself to meaningfully affect @entity1 outcome. Structured feedback and @entity146 consultation appeared adequate to significantly reduce PNES frequency and improve aspects of quality of life, while the addition of a weekly phone contact also led to improved mood.
