Poole Norman, Cope Sarah, Vanzan Serena, Duffus Aimee, Williams Tatiana, Mantovani Nadia, Smith Jared G, Barrett Barbara, Scicluna Martin, Beardmore Sarah, Edwards Mark J, Howard Robert
South West London and St George's Mental Health NHS Trust, London, UK.
Department of Neuropsychiatry, South London and Maudsley NHS Foundation Trust, London, UK.
BJPsych Open. 2025 May 2;11(3):e91. doi: 10.1192/bjo.2025.33.
Functional cognitive disorder is an increasingly recognised subtype of functional neurological disorder for which treatment options are currently limited. We have developed a brief online group acceptance and commitment therapy (ACT)-based intervention.
To assess the feasibility of conducting a randomised controlled trial of this intervention versus treatment as usual (TAU).
The study was a parallel-group, single-blind randomised controlled trial, with participants recruited from cognitive neurology, neuropsychiatry and memory clinics in London. Participants were randomised into two groups: ACT + TAU or TAU alone. Feasibility was assessed on the basis of recruitment and retention rates, the acceptability of the intervention, and signal of efficacy on the primary outcome measure (Acceptance and Action Questionnaire II (AAQ-II)) score, although the study was not powered to demonstrate this statistically. Outcome measures were collected at baseline and at 2, 4 and 6 months post-intervention, including assessments of quality of life, memory, anxiety, depression and healthcare use.
We randomised 44 participants, with a participation rate of 51.1% (95% CI 40.8-61.5%); 36% of referred participants declined involvement, but retention was high, with 81.8% of ACT participants attending at least four sessions, and 64.3% of ACT participants reported being 'satisfied' or 'very satisfied' compared with 0% in the TAU group. Psychological flexibility as measured using the AAQ-II showed a trend towards modest improvement in the ACT group at 6 months. Other measures (quality of life, mood, memory satisfaction) also demonstrated small to modest positive trends.
It has proven feasible to conduct a randomised controlled trial of ACT versus TAU.
功能性认知障碍是功能性神经障碍中一种日益被认可的亚型，目前其治疗选择有限。我们开发了一种基于简短在线团体接纳与承诺疗法（ACT）的干预措施。
评估针对该干预措施与常规治疗（TAU）进行随机对照试验的可行性。
该研究为平行组、单盲随机对照试验，参与者从伦敦的认知神经科、神经精神科和记忆诊所招募。参与者被随机分为两组：ACT+TAU组或仅TAU组。基于招募率和保留率、干预措施的可接受性以及主要结局指标（接纳与行动问卷II（AAQ-II）得分）的疗效信号来评估可行性，尽管该研究没有足够的效力进行统计学证明。在基线以及干预后2、4和6个月收集结局指标，包括生活质量、记忆力、焦虑、抑郁和医疗保健使用情况的评估。
我们随机分配了44名参与者，参与率为51.1%（95%可信区间40.8-61.5%）；36%的被推荐参与者拒绝参与，但保留率很高，81.8%的ACT参与者至少参加了四次疗程，64.3%的ACT参与者报告“满意”或“非常满意”，而TAU组为0%。使用AAQ-II测量的心理灵活性在ACT组6个月时显示出适度改善的趋势。其他指标（生活质量、情绪、记忆满意度）也显示出小到适度的积极趋势。
事实证明，针对ACT与TAU进行随机对照试验是可行的。
