Locum consultant child and adolescent psychiatrist, Harrow CAMHS, CNWL, 322 Northolt Rd, South Harrow, Harrow HA2 8EQ, United Kingdom.
Division of Psychiatry, Imperial College London, 2nd Floor Commonwealth Building, Du Cane Road, London W12 0NN, United Kingdom.
Seizure. 2021 Dec;93:20-31. doi: 10.1016/j.seizure.2021.09.006. Epub 2021 Sep 14.
This article systematically reviews the literature on the effectiveness of psychological interventions for non-epileptic seizures (NES) in children and adolescents.
Embase, Medline and PsycINFO were searched to December 2020, for articles published in English, which used an objective measure to evaluate the outcome of a psychological intervention for NES. Further studies were identified from reference lists and experts in the field were contacted for unpublished studies.
Twelve studies met inclusion criteria. Of these, four were set up with the primary aim of evaluating an intervention of which two used a control group, two were prospective outcome studies and eight looked at retrospective clinical data. Two studies evaluated a single treatment modality, the others multiple treatment components. Overall, psychoeducation, and top-down psychotherapy, such as cognitive therapies, were the most frequent interventions, with recent studies describing body-oriented (bottom-up) approaches. Analysis across all studies identified a range of additional intervention components which included assessment and/or treatment for co-morbidities, liaison with school and support for parents, highlighting the importance of individualised treatment packages.
There is a paucity of studies specifically evaluating interventions for NES. Though a range of approaches have been described in managing this patient group, with generally positive outcomes, it is not possible to conclude from the available literature that one treatment approach is superior to another, though the information may be helpful in developing management guidelines.
本文系统回顾了针对儿童和青少年非癫痫性发作（NES）的心理干预措施的有效性的文献。
检索了 Embase、Medline 和 PsycINFO 数据库，截至 2020 年 12 月，检索到了使用客观测量方法评估 NES 心理干预效果的英文文献。通过参考文献列表和该领域的专家确定了进一步的研究，并联系了未发表的研究。
12 项研究符合纳入标准。其中，4 项研究的主要目的是评估干预措施，其中 2 项使用了对照组，2 项为前瞻性结局研究，8 项回顾性临床数据。两项研究评估了单一治疗模式，其余研究评估了多种治疗成分。总体而言，心理教育和自上而下的心理治疗（如认知疗法）是最常见的干预措施，最近的研究描述了以身体为中心（自下而上）的方法。对所有研究的分析确定了一系列额外的干预成分，包括对共病的评估和/或治疗、与学校的联系以及对父母的支持，突出了个体化治疗方案的重要性。
目前专门评估 NES 干预措施的研究较少。尽管在管理这类患者群体方面已经描述了多种方法，且通常结果较为积极，但从现有文献中无法得出一种治疗方法优于另一种的结论，尽管这些信息可能有助于制定管理指南。
