LaFrance W Curt, Miller Ivan W, Ryan Christine E, Blum Andrew S, Solomon David A, Kelley Joan E, Keitner Gabor I
Department of Psychiatry and Human Behavior, Rhode Island Hospital, Brown Medical School, Providence, RI 02903, USA.
Epilepsy Behav. 2009 Apr;14(4):591-6. doi: 10.1016/j.yebeh.2009.02.016. Epub 2009 Feb 20.
Treatment trials for psychogenic nonepileptic seizures (PNES) are few, despite the high prevalence and disabling nature of the disorder. We evaluated the effect of cognitive behavioral therapy (CBT) on reduction of PNES. Secondary measures included psychiatric symptom scales and psychosocial variables. We conducted a prospective clinical trial assessing the frequency of PNES in outpatients treated using a CBT for PNES manual. Subjects diagnosed with video/EEG-confirmed PNES were treated with CBT for PNES conducted in 12 weekly sessions. Seizure calendars were charted prospectively. Twenty-one subjects enrolled, and 17 (81%) completed the CBT intervention. Eleven of the 17 completers reported no seizures by their final CBT session. Mean scores on scales of depression, anxiety, somatic symptoms, quality of life, and psychosocial functioning showed improvement from baseline to final session. CBT for PNES reduced the number of PNES and improved psychiatric symptoms, psychosocial functioning, and quality of life.
尽管精神性非癫痫性发作(PNES)患病率高且具有致残性,但针对该病症的治疗试验却很少。我们评估了认知行为疗法(CBT)对减少PNES发作的效果。次要指标包括精神症状量表和心理社会变量。我们进行了一项前瞻性临床试验,评估使用针对PNES的CBT手册治疗的门诊患者中PNES的发作频率。被诊断为视频/脑电图证实的PNES患者接受了为期12周的每周一次的针对PNES的CBT治疗。前瞻性地绘制了发作日历。21名受试者入组,17名(81%)完成了CBT干预。17名完成者中有11名在最后一次CBT治疗时报告无发作。从基线到最后一次治疗,抑郁、焦虑、躯体症状、生活质量和心理社会功能量表的平均得分均有所改善。针对PNES的CBT减少了PNES发作次数,改善了精神症状、心理社会功能和生活质量。