Evaluation of a pilot innovative cognitive-behavioral therapy-based psychoeducation group treatment for functional non-epileptic attacks

• Published in: Epilepsy & behavior 2017-05, Vol.70 (Pt A), p.238-244
• Main Authors: Cope, Sarah R, Smith, Jared G, King, Tara, Agrawal, Niruj
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; CBT; Cognitive Therapy - methods; Cognitive Therapy - standards; Dissociative seizures; Female; Functional non-epileptic attacks; Humans; Intervention; Male; Middle Aged; Neurology; Non-epileptic attack disorder; Pilot Projects; Psychogenic nonepileptic seizures; Psychotherapy, Group - methods; Psychotherapy, Group - standards; Seizures - psychology; Seizures - therapy; Surveys and Questionnaires; Therapies, Investigational - methods; Therapies, Investigational - standards; Treatment; Treatment Outcome; Young Adult
• ISSN: 1525-5050; 1525-5069
• DOI: 10.1016/j.yebeh.2017.02.014

Abstract A high proportion of patients presenting at epilepsy clinics experience functional non-epileptic attacks (FNEA), and while psychological treatment is generally thought to be the required intervention, evidence regarding psychological treatment of FNEA is limited. A small number of psychoeducation treatments have been evaluated, with promising results. As part of routine care within a neuropsychiatry service, a 3-session cognitive-behavior therapy- (CBT-) informed psychoeducation group was developed. Patients with comorbid epilepsy were included. The group's effectiveness was evaluated in terms of attack frequency, mood, illness perception, dissociative experiences, and patient feedback. Pre- and post-treatment data were obtained for 19 patients. The proportion of patients experiencing attacks significantly decreased, with almost 40% of treatment completers reporting being attack-free at the end of treatment. Significant improvements were also found on level of psychological distress, illness beliefs, and understanding of the condition. No significant changes in mood or general functioning were observed. High satisfaction was reported by almost all patients. Treatment outcome was not significantly affected by the level of dissociative experiences. The results suggest that CBT-based psychoeducation group treatment can be a beneficial part of treatment for those with FNEA, even for those experiencing high levels of dissociation. Further controlled studies with larger sample sizes are required.