Haritsa Sneha Vinay, Reddy Kalapalli Jayasankara, Rafiq Aeiman, Gupta Meghna
Dept. of Psychology, CHRIST (Deemed to be University), Bangalore, Karnataka, India.
Amity Institute of Psychology and Allied Sciences, Amity University, Sector 125, Noida, Uttar Pradesh, India.
Indian J Psychol Med. 2021 Nov;43(6):469-472. doi: 10.1177/02537176211047392. Epub 2021 Oct 25.
Psychotherapy improves seizure frequency and psychosocial aspects in psychogenic nonepileptic seizures (PNES). Although randomized controlled trials (RCTs) on different psychotherapies have been conducted for almost two decades now, no review has exclusively assessed RCTs of different psychotherapies.
The objective was to review RCTs of psychotherapy for PNES, to understand the impact of different psychotherapies. Eligibility criteria included full-text articles, English articles, published between years 2000 and 2020, randomized trials of psychotherapy, and the adult population. Databases included PubMed, ProQuest, Google Scholar, ScienceDirect, EBSCO, PsycINFO, Cochrane, and a random google search was conducted. Rayyan software was used to include articles that met our eligibility criteria. The search was carried out independently by two researchers.
Based on the eligibility criteria, seven studies were found. Amongst them, cognitive behavioral therapy (CBT) was the most researched and seemed more effective when paired with standard medical care (SMC) or sertraline. Comparisons of CBT and brief psychodynamic therapy did not reveal significant differences. Other psychotherapies included motivational interview+psychotherapy, which significantly reduced seizure frequency and improved psychosocial functioning. Paradoxical intention therapy also reduced PNES symptoms; however, it has not been researched in the last 15 years. Group psychoeducation seems to have an impact only on psychosocial functioning and not on seizure frequency.
CBT paired with SMC or sertraline and MI along with psychotherapy yields the most effective results for PNES in reducing seizure frequency and improving psychosocial functioning.
心理治疗可改善心因性非癫痫性发作（PNES）的发作频率及心理社会状况。尽管针对不同心理治疗方法的随机对照试验（RCT）已开展了近二十年，但尚无综述专门评估不同心理治疗方法的RCT。
目的是回顾针对PNES的心理治疗RCT，以了解不同心理治疗方法的影响。纳入标准包括2000年至2020年间发表的全文英文文章、心理治疗的随机试验以及成年人群。数据库包括PubMed、ProQuest、谷歌学术、ScienceDirect、EBSCO、PsycINFO、Cochrane，并进行了随机谷歌搜索。使用Rayyan软件纳入符合纳入标准的文章。搜索由两名研究人员独立进行。
根据纳入标准，共找到七项研究。其中，认知行为疗法（CBT）研究最多，与标准医疗护理（SMC）或舍曲林联合使用时似乎更有效。CBT与短程心理动力疗法的比较未显示出显著差异。其他心理治疗方法包括动机访谈+心理治疗，可显著降低发作频率并改善心理社会功能。矛盾意向疗法也可减轻PNES症状；然而，在过去15年中尚未对其进行研究。团体心理教育似乎仅对心理社会功能有影响，而对发作频率无影响。
CBT与SMC或舍曲林联合使用以及动机访谈与心理治疗相结合，在降低PNES发作频率和改善心理社会功能方面产生的效果最为显著。
