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  • Psychiatry versus general physicians: who is better at differentiating epileptic from psychogenic non-epileptic seizures?

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    MacDonaldPUB4684.pdf (122.2Kb)
    Author(s)
    MacDonald, Tim
    Hill, Aron
    Phan, Thanh
    Fitzgerald, Paul
    Seneviratne, Udaya
    Griffith University Author(s)
    MacDonald, Tim S.
    Year published
    2012
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    Abstract
    Objective: To determine how accurately psychiatry and general medical doctors can differentiate epileptic and psychogenic non-epileptic seizures based on videotaped events (closest proxy to witnessed events). This study aims to establish how confidently this distinction can be made, the reasons why a particular diagnosis is reached, and inter-rater agreement. Methods: 18 videos of patients demonstrating a heterogeneous mixture of epileptic and psychogenic non-epileptic seizures were collected and ordered in a random mix. These videos were shown to groups of general physicians, medical registrars and residents (n=19) as well ...
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    Objective: To determine how accurately psychiatry and general medical doctors can differentiate epileptic and psychogenic non-epileptic seizures based on videotaped events (closest proxy to witnessed events). This study aims to establish how confidently this distinction can be made, the reasons why a particular diagnosis is reached, and inter-rater agreement. Methods: 18 videos of patients demonstrating a heterogeneous mixture of epileptic and psychogenic non-epileptic seizures were collected and ordered in a random mix. These videos were shown to groups of general physicians, medical registrars and residents (n=19) as well as to psychiatrists and psychiatry registrars (n=8) who were provided with a questionnaire. Results: A total of 27 doctors participated in the study. The overall percentage of correct diagnoses was 55.4%. There were no significant differences in correct diagnosis rates between psychiatry and general medical doctors. There was poor inter-rater agreement (Kappa = 0.159). Neither group was particularly confident in reaching a diagnosis, and diverse reasons underpinned the diagnoses given. Conclusion: Among the participants, merely observing an epileptic or non-epileptic event is insufficient to establish a definitive diagnosis. The results indicate poor diagnostic accuracy and agreement among psychiatry and general medical doctors. This may have important implications for both education and clinical practice.
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    Journal Title
    Australasian Psychiatry
    Volume
    20
    Issue
    5
    DOI
    https://doi.org/10.1177/1039856212458462
    Copyright Statement
    MacDonald et al, Psychiatry versus general physicians: who is better at differentiating epileptic from psychogenic non-epileptic seizures?, Australasian Psychiatry, 20(5) 379–383, 2012. Copyright 2012 The Authors. Reprinted by permission of SAGE Publications.
    Subject
    Central Nervous System
    Medical and Health Sciences
    Psychology and Cognitive Sciences
    Publication URI
    http://hdl.handle.net/10072/370875
    Collection
    • Journal articles

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