A survey about laughter upon viewing functional seizures

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Introduction: Laughter among physicians when observing clinical manifestations of functional seizures (FS) or other functional disorders is frequently noted. This reflexive response can occur both in clinical practice and during video presentations at medical conferences. We examine the underlying factors contributing to physicians' laughter in response to the diagnosis of FS. Methods: The research, spanning 5 years and diverse geographical locations, surveyed 221 participants, including physicians and non-physicians, to understand the reasons behind laughter during FS diagnoses. Results: A total of 221 respondents (estimated 20-25% of attendees) completed the survey, with 56% identifying as physicians and 44% as non-physicians. Observational data showed laughter responses to FS videos varied widely across settings: approximately 57% at U. S. medical grand rounds, compared to 5-17% at international conferences, and 0% among non-medical audiences. Survey analysis revealed 10 thematic categories for reasons behind laughter, with significant differences between physicians and non-physicians. Non-physicians more frequently cited defense mechanisms, negative opinions, and ignorance, whereas physicians more often attributed laughter to superiority, diagnostic skepticism, or perceived patient deception. U. S. physicians were significantly more likely than non-U. S. physicians to report discomfort, negative opinions, and ignorance. No significant differences were found between neurologists and internists. Significance: Laughter may serve multifaceted adaptive functions in response to the complexities of diagnosing and managing patients with FS. By highlighting misperceptions surrounding functional disorders, the study underscores the importance of fostering a deeper understanding among clinicians to ensure equitable care for patients experiencing FS.

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