Cognitive-behavioral therapy for psychogenic nonepileptic seizures: a pilot RCT

Goldstein, L H, Chalder, T, Chigwedere, C, Khondoker, M R ORCID: https://orcid.org/0000-0002-1801-1635, Moriarty, J, Toone, B K and Mellers, J D C (2010) Cognitive-behavioral therapy for psychogenic nonepileptic seizures: a pilot RCT. Neurology, 74 (24). pp. 1986-1994. ISSN 0028-3878

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Abstract

Objective: To compare cognitive-behavioral therapy (CBT) and standard medical care (SMC) as treatments for psychogenic nonepileptic seizures (PNES).  Methods: Our randomized controlled trial (RCT) compared CBT with SMC in an outpatient neuropsychiatric setting. Sixty-six PNES patients were randomized to either CBT (plus SMC) or SMC alone, scheduled to occur over 4 months. PNES diagnosis was established by video-EEG telemetry for most patients. Exclusion criteria included comorbid history of epilepsy, <2 PNES/month, and IQ <70. The primary outcome was seizure frequency at end of treatment and at 6-month follow-up. Secondary outcomes included 3 months of seizure freedom at 6-month follow-up, measures of psychosocial functioning, health service use, and employment.  Results: In an intention-to-treat analysis, seizure reduction following CBT was superior at treatment end (group × time interaction p < 0.0001; large to medium effect sizes). At follow-up, the CBT group tended to be more likely to have experienced 3 months of seizure freedom (odds ratio 3.125, p = 0.086). Both groups improved in some health service use measures and on the Work and Social Adjustment Scale. Mood and employment status showed no change.  Conclusions: Our findings suggest that cognitive-behavioral therapy is more effective than standard medical care alone in reducing seizure frequency in PNES patients.

Item Type:	Article
Uncontrolled Keywords:	adult,cognitive therapy,epilepsy,female,follow-up studies,humans,male,middle aged,pilot projects,seizures,treatment outcome,young adult
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Groups > Epidemiology and Public Health Faculty of Medicine and Health Sciences > Research Groups > Public Health and Health Services Research (former - to 2023) Faculty of Science > Research Groups > Norwich Epidemiology Centre Faculty of Medicine and Health Sciences > Research Groups > Norwich Epidemiology Centre Faculty of Medicine and Health Sciences > Research Centres > Population Health
Depositing User:	Pure Connector
Date Deposited:	24 Sep 2016 00:40
Last Modified:	19 Oct 2023 01:46
URI:	https://ueaeprints.uea.ac.uk/id/eprint/60176
DOI:	10.1212/WNL.0b013e3181e39658

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