Abstracts

Rationale: Numerous articles have reported the prevalence of mental health stigma (MHS) and somatization (SOM) in many cultural communities throughout the world. MHS can be defined as disbeliefs or negative beliefs about mental illness and treatment. SOM can be defined as the tendency to manifest psychological illnesses with physical symptoms. MHS and SOM are significant to the practice of neurology because individuals with MHS and SOM tend to seek medical (neurological) diagnoses and treatment rather than mental health services for their psychological afflictions. It is proposed that this aversion to mental health services results in underdiagnosing PNES in patients diagnosed with exclusive epilepsy.
_x000D_ This study examined if MHS and SOM differences would be found between: (1) Latino and Non-Hispanic Caucasian (NHC) neurology patients, and (2) two Diagnostic Membership Groups (DMG); DMG 1 – composed of individuals diagnosed with exclusive PNES or Comorbid PNES and Epilepsy, and DMG 2 – composed of individuals diagnosed with Exclusive Epilepsy.

Methods: Seventeen male and female patients scheduled for clinic visits in neurology at Spectrum Health in Grand Rapids, Michigan were recruited for this study. Participants ranged in age from 20 to 76 and completed a Demographic Background Questionnaire, an MHS scale, and a SOM scale.

Results: Four expected findings were identified: (1) Latinos had 66.07% higher MHS mean scores than NHC’s; (2) Latinos had 114% higher Acute SOM mean scores than NHC’s; (3) Latinos had 74.47% higher Chronic SOM mean scores than NHC’s; and (4) individuals in DMG 1 had 20.65% higher MHS mean scores than individuals in DMG 2; 84.85% higher Acute SOM mean scores than individuals in DMG 2; and 63.98% higher Chronic SOM mean scores than DMG 2. Additionally: (1) 67% of individuals in DMG 1 had elevated levels of MHS, Acute SOM and Chronic SOM (defined as one or two standard deviations above the total sample group MHS, Acute SOM and Chronic SOM means); and (2) 37% of individuals in DMG 2 had elevated levels of MHS, Acute SOM and Chronic SOM (as defined above).

Conclusions: Results of this exploratory study showed a descriptive statistical relation among: (1) ethnicity and MHS, Acute SOM and Chronic SOM; and (2) DMG and MHS, Acute SOM, and Chronic SOM. Results are significant to the practice of neurology because they strongly suggest that PNES and Comorbid PNES and Epilepsy may be underdiagnosed among some patients diagnosed with Exclusive Epilepsy. Moreover, given that: (1) PNES is a mental health disorder; (2) the extant literature indicates that patients and caregivers with MHS are not likely to seek mental health services; and (3) neurology is the first stop for patients presenting with symptoms that suggest epileptic seizures, the results of this exploratory study support the use of screening instruments such as MHS and SOM scales to help determine who is most likely to benefit from mental health treatment in addition to or instead of medical and surgical neurological intervention.

Funding: Not applicable