Unveiling Saudi Physicians' knowledge and attitude toward Psychogenic nonepileptic seizures (PNES): A cross-sectional study.

Objectives: To assess the knowledge and attitudes of Saudi physicians from different specialties towards Psychogenic Non-Epileptic Seizures (PNES) and identify the challenges faced in managing this condition.

Methods: In November 2023, a questionnaire was distributed online to physicians through official targeted medical specialties societies. In February 2024 the study was closed. The survey was conducted in English, including questions about socio-demographics, knowledge about PNES's clinical presentation, diagnosis, management, respondents' experience, confidence and challenges in handling PNES cases.

Results: A total of 222 responses were collected. The overall knowledge score was 34.51 ± 9.67 out of 60, with 64.9 % of participants demonstrating good knowledge (score ≥ 50 %) and 35.1 % showing poor knowledge (score < 50 %). The overall attitude score was 21.65 ± 7.49 out of 40, with 55.4 % of participants demonstrating a favorable attitude towards PNES diagnosis & management (score ≥ 50 %), while 44.6 % displayed an unfavorable attitude (score < 50 %). Neurologists and psychiatrists exhibited higher knowledge and more positive attitudes compared to other specialties. Emergency physicians, internists, and pediatricians showed the lowest scores of knowledge & attitudes. Significant challenges included a lack of knowledge (41.0 %), insufficient diagnostic resources (35.6 %), and poor cross-disciplinary collaboration (36.0 %).

Significance: There is a critical need for improved knowledge about PNES characteristics, management, and training resources to enhance physicians' attitudes toward PNES patients, particularly among specialties that frequently encounter these patients. Addressing the identified gaps can lead to better patient outcomes through timely diagnosis and appropriate treatment referrals.