Carlson Perri, Nicholson Perry Kathryn
Australian College of Applied Psychology, Level 11, 255 Elizabeth Street, Sydney, NSW 2000, Australia.
Seizure. 2017 Feb;45:142-150. doi: 10.1016/j.seizure.2016.12.007. Epub 2016 Dec 21.
The aim of this meta-analysis is to evaluate and synthesize the available evidence from the previous 20 years regarding the utility of psychological interventions in the management of psychogenic non-epileptic seizures (PNES).
Studies were retrieved from MEDLINE via OvidSP and PsychINFO. Selection criteria included controlled and before-after non-controlled studies including case series, using seizure frequency as an outcome measurement. Studies were required to assess one or more types of psychological intervention for the treatment of PNES in adults. Data from 13 eligible studies was pooled to examine the effectiveness of psychological interventions in treating PNES on two primary outcomes: seizure reduction of 50% or more and seizure freedom. A meta-analysis was conducted with data extracted from 228 participants with PNES.
Interventions reviewed in the analysis included CBT, psychodynamic therapy, paradoxical intention therapy, mindfulness and psychoeducation and eclectic interventions. Meta-analysis synthesized data from 13 studies with a total of 228 participants with PNES, of varied gender and age. Results showed 47% of people with PNES are seizure free upon completion of a psychological intervention. Additional meta-analysis synthesized data from 10 studies with a total of 137 participants with PNES. This analysis found 82% of people with PNES who complete psychological treatment experience a reduction in seizures of at least 50%.
The studies identified for this analysis were diverse in nature and quality. The findings highlight the potential for psychological interventions as a favorable alternative to the current lack of treatment options offered to people with PNES.
本荟萃分析的目的是评估并综合过去20年中关于心理干预在精神性非癫痫性发作（PNES）管理中的效用的现有证据。
通过OvidSP从MEDLINE和PsychINFO检索研究。选择标准包括对照研究和前后非对照研究（包括病例系列），以发作频率作为结果测量指标。研究需评估一种或多种心理干预措施对成人PNES的治疗效果。汇总了13项符合条件的研究数据，以检验心理干预在治疗PNES方面对两个主要结果的有效性：发作减少50%或更多以及无发作。对从228名患有PNES的参与者中提取的数据进行了荟萃分析。
分析中审查的干预措施包括认知行为疗法（CBT）、精神动力疗法、矛盾意向疗法、正念和心理教育以及综合干预措施。荟萃分析综合了13项研究的数据，共有228名患有PNES的参与者，性别和年龄各异。结果显示，47%的PNES患者在完成心理干预后无发作。另外的荟萃分析综合了10项研究的数据，共有137名患有PNES的参与者。该分析发现，82%完成心理治疗的PNES患者发作减少至少50%。
本次分析确定的研究在性质和质量上各不相同。研究结果突出了心理干预作为一种有利选择的潜力，可以替代目前PNES患者缺乏治疗选择的现状。
