Brief group psychoeducation for psychogenic nonepileptic seizures: A neurologist-initiated program in an epilepsy center *†David K. Chen, *Atul Maheshwari, †Romay Franks, ‡Gregory C. Trolley, §Jordan S. Robinson, and *†Richard A. Hrachovy Epilepsia, 55(1):156–166, 2014 doi: 10.1111/epi.12481 David K. Chen is Assistant Professor of Neurology at Baylor College of Medicine. SUMMARY Objective: To evaluate therapeutic efficacy upon augmenting the initial communica- tion to patients regarding the diagnosis of psychogenic nonepileptic seizures (PNES) with a novel, brief group psychoeducation administered by the same team that pro- vided the video–electroencephalography (VEEG) confirmed diagnosis and within 4 weeks of the diagnosis. Methods: Prior to discharge from the epilepsy monitoring unit (EMU), a standardized communication strategy was utilized to explain the diagnosis of PNES to all patients prior to enrollment. Enrolled patients were then randomized to either participation in three successive and monthly group psychoeducational sessions (intervention group), or routine seizure clinic follow-up visits (control group). Both groups completed ques- tionnaires at time of enrollment, and then at approximately 3 months (follow-up 1) and 6 months (follow-up 2) after discharge, assessing for: (1) primary outcomes that include a measure of psychosocial functioning, as well as interval difference in seizure frequency/ intensity; and (2) secondary outcomes that include interval seizure-related emergency room visits or hospitalizations, development of new and medically unexplained symp- toms, and results of an internal measure of knowledge and perception outcomes. Results: The majority (73%) of patients from the intervention group commenced on therapy sessions within 4 weeks after learning of the diagnosis. Although we did not observe significant group difference in seizure frequency/intensity, patients from the intervention group showed significant improvement on the Work and Social Adjust- ment Scale (WSAS) scores at both follow-up 1 (p = 0.013) and follow-up 2 (p = 0.038) after discharge from the EMU. In addition, we observed a trend toward lesser likeli- hood for seizure-related emergency room visits or hospitalizations for the interven- tion group (p = 0.184), as well as meaningful insights from an internal measure of intervention outcomes. Significance: These findings suggest that our cost/resource effective, brief group psy- choeducational program, when administered early and by the same team who con- firmed and communicated the diagnosis of PNES, may contribute to significant functional improvement among participating patients. KEY WORDS: Psychogenic nonepileptic seizures, Psychotherapy, Psychoeducation, Work and Social Adjustment Scale, Psychosocial functioning. Accepted October 16, 2013; Early View publication December 20, 2013. *Peter Kellaway Section of Neurophysiology, Department of Neurology, Baylor College of Medicine, Houston, Texas, U.S.A.; †Neurology Care Line, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, U.S.A.; ‡Department of Neurology, Baylor College of Medicine, Houston, Texas, U.S.A.; and §Department of Psychology and Behavioral Sciences, Baylor College of Medicine, Mental Health Care Line, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas,U.S.A. Address correspondence to David K. Chen, MEDVAMC, 2002 Holcombe Blvd., NCL 127, Houston, TX 77030, U.S.A. E-mail: dkchen@bcm.edu Wiley Periodicals, Inc. © 2013 International League Against Epilepsy 156 FULL-LENGTH ORIGINAL RESEARCH