Illness perceptions of neurologists and psychiatrists in relation to epilepsy and nonepileptic attack disorder

Previous studies have demonstrated that the illness perceptions of doctors can affect treatment outcomes. This is likely to be particularly relevant in chronic disorders such as epilepsy or nonepileptic attack disorder (NEAD) in which treatment success depends on adherence to tablet treatments with significant side effects or a potentially difficult process of engagement in psychological treatment. This study describes the illness perceptions of neurologists and psychiatrists to epilepsy and NEAD. 85 doctors (45 neurologists and 40 psychiatrists) completed the adapted Illness Perception Questionnaire-Revised (IPQ-R) and the Symptom Attribution Question for epilepsy and NEAD. Both groups of doctors thought that patients with NEAD had greater personal control over their condition than patients with epilepsy (p<.02) and that NEAD was a more cyclical condition than epilepsy (p<.001). Both groups of doctors professed a greater understanding of epilepsy than NEAD (p<.001). Psychiatrists alone believed epilepsy to be more chronic than NEAD (p=.002). Psychiatrists felt that epilepsy had less of an emotional impact on patients (p=.004) and were more likely to endorse psychological causes for epilepsy (p=.008) when compared to neurologists. Psychiatrists felt that NEAD had less negative consequences (p=.014) and were more likely to endorse nonpsychological causes for NEAD (p=.020) when compared to neurologists. The IPQ-R and Symptom Attribution Question demonstrated important differences in attitudes of neurologists and psychiatrists towards epilepsy and NEAD. Different attitudes towards the two seizure disorders may cause problems with communication and treatment if patients are referred from one speciality to the other.