Screening Gaps, Stigma & Misdiagnosis Plague Patients with Pseudobulbar Affect, Neurologists' Paper Explains

Clinical proceedings paper details prevalence, impact of disease marked by uncontrollable emotional outbursts

TALLAHASSEE, Fla., Nov. 9, 2022 /PRNewswire/ -- Uncontrollable crying and laughing are the common symptoms of pseudobulbar affect, a prevalent yet overlooked neurological disorder that's the focus of a new white paper from the Clinical Neurological Society of America. The paper features neurologists' insights on the stigma and treatment barriers faced by those with the disease, which impacts more than a third of patients with neurological injury or disease.

Known as PBA, the condition's trademark outbursts of laughing or, more commonly, crying don't reflect patients' actual emotional state. The disease, which is highly stigmatized, can affect patients with a brain injury or neurodegenerative condition, such as a stroke, traumatic brain injury, Alzheimer's or Parkinson's disease. Despite its prevalence and devastating impact, PBA is often misdiagnosed. Screening is rare, the paper notes, and patients who are diagnosed with the disease face barriers to treatment.

Family members, colleagues and even patients themselves often struggle with PBA because they often don't fully understand the disease and the disconnect between disease-related outbursts and patients' real emotions, the paper explains.

Barriers to Diagnosis & Costs of Untreated PBA

Primary care providers may lack training and education to recognize symptoms as PBA rather than depression. While there is one FDA-approved medication for PBA, antidepressants are often used instead, despite lack of rigorous evidence in large clinical studies. Half of patients with pseudobulbar affect don't receive treatment for their actual symptoms, the paper notes.

Meanwhile, the economic and personal toll grows. The health care utilization costs of mild pseudobulbar affect are 32% higher than costs for people with low or no symptoms and 102% higher for those with moderate-to-severe symptoms. Personal costs are also a factor, the paper explains, as patients report being fired, watching their marriages fail or becoming housebound due to the disease.

Learn more by reading, "Pseudobulbar Affect: A Prevalent Yet Overlooked Disorder in Neurological Injury & Disease."

STATEMENT FROM PHILIP B. GORELICK, MD, MPH, CHAIR, CNSA CLINICAL PROCEEDINGS EXPERT PANEL:

"Given the gap we now see between disease prevalence and treatment, this paper offers an important reminder of the need to better educate health care providers, patients and family members alike about the impact of PBA."

The Clinical Neurological Society of America, a non-profit 501(c)(6), is a nationwide organization of neurology clinicians with a mission to improve clinical practice and patient care through education. 

SOURCE Clinical Neurological Society of America