Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, Fitzrovia, London W1T 7BN, UK.
Neuropsychiatry Department, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK.
Epilepsy Behav. 2020 May;106:106993. doi: 10.1016/j.yebeh.2020.106993. Epub 2020 Mar 10.
The main aim of this study was to assess the effectiveness of cognitive behavior therapy (CBT) for comorbid dissociative seizures (DS) in patients with epilepsy.
We conducted a retrospective case note review of 14 patients with epilepsy who underwent outpatient CBT for DS in a tertiary neuropsychiatry service. The diagnosis of DS was confirmed by neurologists clinically and/or following video-telemetry electroencephalogram (EEG). We evaluated the outcome of the CBT treatment with respect to frequency of DS, measures of depression, anxiety, and social functioning.
Measures of depression and anxiety significantly reduced following CBT treatment. Overall, frequency of DS reduced following CBT treatment but did not reach statistical significance.
This study provides evidence that CBT can be effective in reducing depression and anxiety in patients with both epilepsy and DS. Anxiety and depression are likely to be associated with DS. Further research in larger samples and longitudinal studies are recommended to evaluate the long-term efficacy of CBT in this patient group.
本研究的主要目的是评估认知行为疗法（CBT）对癫痫伴发分离性癫痫发作（DS）患者的疗效。
我们对在一家三级神经精神病学服务机构接受门诊 CBT 治疗 DS 的 14 例癫痫患者进行了回顾性病历审查。DS 的诊断由神经病学家通过临床和/或视频遥测脑电图（EEG）确认。我们根据 DS 的频率、抑郁、焦虑和社会功能的测量评估 CBT 治疗的结果。
CBT 治疗后抑郁和焦虑的测量显著降低。总体而言，DS 的频率在 CBT 治疗后降低，但未达到统计学意义。
本研究提供了证据表明，CBT 可有效降低癫痫伴发 DS 患者的抑郁和焦虑。焦虑和抑郁可能与 DS 有关。建议在更大样本和纵向研究中进一步研究，以评估 CBT 在该患者群体中的长期疗效。
