King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK.
Academic Neurology Unit, University of Sheffield, Royal Hallamshire Hospital, Sheffield S10 2JF, UK.
Epilepsy Behav. 2020 Oct;111:107230. doi: 10.1016/j.yebeh.2020.107230. Epub 2020 Jul 5.
Nested within a large, multicenter randomized controlled trial (RCT) for people with dissociative seizures (DS), the study used purposive sampling to explore participants' experience of participating in an RCT, their experience of DS-specific cognitive behavioral therapy (CBT) and another component of the RCT, Standardized Medical Care (SMC) and their perceptions of and reflections on seizure management and change.
A qualitative study using semistructured interviews was conducted with 30 participants in an RCT (the COgnitive behavioral therapy vs standardized medical care for adults with Dissociative non-Epileptic Seizures (CODES) Trial) investigating the effectiveness of two treatments for DS. Key themes and subthemes were identified using thematic framework analysis (TFA).
Analysis yielded three overarching themes: taking part in a treatment trial - "the only thing out there", the experience of treatment techniques that were perceived to help with seizure management, and reflections on an "unpredictable recovery".
People with DS are amenable to participating in a psychotherapy RCT and described a largely positive experience. They also described the applicability of aspects of DS-specific CBT and SMC in the management of their DS, received within the confines of the CODES trial. Factors that appeared to account for the variability in response to treatment delivery included individual preferences for the nature of sessions, the nature of therapeutic relationships, readiness to discuss trauma, other aspects of emotional avoidance, and whether therapy provided something new.
在一项针对分离性癫痫发作（DS）患者的大型、多中心随机对照试验（RCT）中，该研究采用目的性抽样方法，探讨了参与者参与 RCT 的体验、他们对特定于 DS 的认知行为疗法（CBT）和 RCT 的另一个组成部分——标准医疗护理（SMC）的体验，以及他们对癫痫发作管理和变化的看法和反思。
使用半结构化访谈对一项 RCT（即 COgnitive behavioral therapy vs standardized medical care for adults with Dissociative non-Epileptic Seizures (CODES) Trial）中的 30 名参与者进行了一项定性研究，该研究旨在调查两种治疗 DS 的方法的有效性。使用主题框架分析（TFA）确定了主要主题和子主题。
分析产生了三个总体主题：参与治疗试验——“唯一的出路”、治疗技术的体验，这些技术被认为有助于癫痫发作管理，以及对“不可预测的康复”的反思。
DS 患者愿意参与心理治疗 RCT，并描述了一个基本积极的体验。他们还描述了在 CODES 试验中特定于 DS 的 CBT 和 SMC 的各个方面在 DS 管理中的适用性。似乎导致治疗效果个体差异的因素包括对治疗性质的个人偏好、治疗关系的性质、是否准备讨论创伤、其他情感回避方面，以及治疗是否提供了新的内容。
