The Epilepsy Clinic, Rigshospitalet-Glostrup, Denmark.
The Epilepsy Clinic, Rigshospitalet-Glostrup, Denmark.
Epilepsy Behav. 2019 Sep;98(Pt A):195-200. doi: 10.1016/j.yebeh.2019.05.007. Epub 2019 Aug 1.
Psychogenic nonepileptic seizures (PNES) are known to be associated with significant costs of healthcare services. Here, we report the impact of psychotherapy on behavior surrounding healthcare utilization and the potential economic benefits associated with long-term seizure control.
This retrospective study describes patients seen between 2010 and 2016 at the epilepsy clinic at Glostrup University Hospital in Denmark and offered a psychotherapeutic treatment program for PNES. Forty-two patients were interviewed about seizure outcome 12-24 months after psychotherapy, and the annual changes in healthcare utilization and associated costs of services provided in a period of 24 months before and up to 24 months after treatment were compared.
At 12-month follow-up, 83% of the patients had achieved above 50% reduction in seizures. The 24-month pretreatment costs compared with the 24-month posttreatment costs directly associated with seizures dropped by 95.8%, and total healthcare costs were reduced by 63%. Estimation of annual savings from the program comes to 1060 € per patient. An association was found between seizure rate and number of healthcare contacts.
This study adds to the evidence that psychotherapy is a cost-effective way of treating PNES. The economic benefits from this form of intervention appear not only to diminish costs directly associated with PNES, but also healthcare utilization in general.
已知心因性非癫痫性发作（PNES）与医疗保健服务的大量成本相关。在此，我们报告心理治疗对围绕医疗保健利用的行为的影响，以及与长期癫痫控制相关的潜在经济效益。
这项回顾性研究描述了丹麦格罗斯楚普大学医院癫痫诊所于 2010 年至 2016 年间就诊的患者，并为 PNES 提供心理治疗方案。42 名患者在接受心理治疗后 12-24 个月接受了关于癫痫发作结果的访谈，并比较了治疗前 24 个月和治疗后 24 个月期间医疗保健利用和相关服务成本的年度变化。
在 12 个月的随访中，83%的患者癫痫发作减少了 50%以上。与癫痫直接相关的 24 个月治疗前成本与 24 个月治疗后成本相比下降了 95.8%，总医疗保健成本下降了 63%。该方案的年度节省估计为每位患者 1060 欧元。发现癫痫发作率与医疗保健接触次数之间存在关联。
这项研究增加了心理治疗是治疗 PNES 的一种具有成本效益的方法的证据。这种干预形式的经济效益不仅似乎降低了与 PNES 直接相关的成本，而且还降低了一般医疗保健的利用。
