Psychogenic non-epileptic seizures and psychoanalytical treatment:                results

Santos, Niraldo de Oliveira; Benute, Gláucia Rosana Guerra; Santiago, Alessandra; Marchiori, Paulo Eurípedes; Lúcia, Mara Cristina Souza de

doi:10.1590/1806-9282.60.06.018

Cited by 24 publications

(12 citation statements)

References 30 publications

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“…We identified 19 relevant studies, [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] the characteristics and full author list of which are outlined in table 1. Elsewhere these studies are referred to by the first author's surname followed by the year of publication.…”

Section: Resultsmentioning

confidence: 99%

Systematic review of psychotherapy for adults with functional neurological disorder

Gutkin¹,

McLean²,

Brown

et al. 2020

J Neurol Neurosurg Psychiatry

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Functional neurological disorder (FND) is a common and disabling disorder that is often considered difficult to treat, particularly in adults. Psychological therapies are often recommended for FND. Outcome research on psychological therapies for FND has grown in recent years but has not been systematically evaluated since 2005. This study aims to build on that by systematically reviewing the evidence-base for individual outpatient cognitive behavioural and psychodynamic psychotherapies for FND. Medical databases were systematically searched for prospective studies of individual outpatient psychotherapy for FND with at least five adult participants. Studies were assessed for methodological quality using a standardised assessment tool. Results were synthesised, and effect sizes calculated for illustrative purposes. The search strategy identified 131 relevant studies, of which 19 were eligible for inclusion: 12 examining cognitive behavioural therapy (CBT) and 7 investigating psychodynamic therapy (PDT). Eleven were pre–post studies and eight were randomised controlled trials. Most studies recruited a single symptom-based subtype rather than all presentations of FND. Effect sizes, where calculable, showed generally medium-sized benefits for physical symptoms, mental health, well-being, function and resource use for both CBT and PDT. Outcomes were broadly comparable across the two therapy types, although a lack of high-quality controlled trials of PDT is a significant limitation, as is the lack of long-term follow-up data in the majority of identified CBT trials. In conclusion, both CBT and PDT appear to potentially offer some benefit for FND, although better quality studies are needed.

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Section: Resultsmentioning

confidence: 99%

Systematic review of psychotherapy for adults with functional neurological disorder

Gutkin¹,

McLean²,

Brown

et al. 2020

J Neurol Neurosurg Psychiatry

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“… 54% reported seizure reduction Chen et al (2013) USA 95 Randomized controlled trial n=64 Three successive monthly, 1.5 h long group sessions No significant group difference in seizure frequency/intensity between groups was found Zaroff et al (2004) USA 94 Before-after, non-controlled study n=10 Group psychoeducational program 3 groups (10x1h/week) 75% reported seizure freedom Cope et al (2017) UK 97 Before-after, non-controlled study n=19 3-session cognitive-behavior therapy-informed psychoeducation group 40% reported seizure freedom at the end of treatment. 63% reported seizure reduction during the intervention period Sharpe et al (2011) UK 98 Randomized controlled efficacy trial n=125 CBT-based self-help workbook and face-to-face guidance sessions No data available about seizure frequency Sarudiansky et al (2020) Argentina 99 Before-after non-controlled study n=12 3- group session cognitive behavioral based psychoeducation 42% reported a reduction in seizure frequency after the intervention Group therapy Barry et al (2008) USA 100 Before-after, non-controlled study n=7 Group psychodynamic therapy (1x week for 32 weeks) 57% reported seizure freedom Other Interventions de Oliveira Santos et al (2014) Brazil 107 Before-after, non-controlled study n=37 Individual psychoanalysis (1x50 min/week for 12 months) 30% reported seizure freedom Kuyk et al (2008) Netherlands 101 Before-aft...…”

Section: Methodsmentioning

confidence: 99%

“…De Oliveira Santos et al applied individual psychoanalysis, and reported a 30% of seizure-freedom in patients with PNES. 107 …”

Section: Methodsmentioning

confidence: 99%

“…De Oliveira Santos et al applied individual psychoanalysis, and reported a 30% of seizurefreedom in patients with PNES. 107 Eye Movement Desensitization and Reprocessing, and Paradoxical Interventions for Patients with PNES EMDR has been proposed for the treatment of PNES given its use as a therapeutic strategy in patients with posttraumatic stress disorder (PTSD). However, it has not shown sufficient positive results in the treatment of PNES, either as a first-line treatment or as part of https://doi.org/10.2147/NDT.S286710…”

Section: Psychodynamic Therapies For Patients With Pnesmentioning

confidence: 99%

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Updated Review on the Diagnosis and Primary Management of Psychogenic Nonepileptic Seizure Disorders

Lanzillotti

Sarudiansky

Lombardi

et al. 2021

NDT

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Psychogenic nonepileptic seizures (PNES) are paroxystic and episodic events associated with motor, sensory, mental or autonomic manifestations, which resemble epileptic seizures (ES), but are not caused by epileptogenic activity. PNES affect between 20% and 30% of patients attending at epilepsy centers and constitute a serious mental health problem. PNES are often underdiagnosed, undertreated and mistaken with epilepsy. PNES are diagnosed after medical causes (epilepsy, syncope, stroke, etc.) have been ruled out, and psychological mechanisms are involved in their genesis and perpetuation. For psychiatry, there is not a single definition for PNES; the DSM-IV and ICD-10/11 describe the conversion and dissociative disorders, and the DSM-5 describes the functional neurological disorders. However, patients with PNES also have a high frequency of other comorbidities like depression, particularly trauma and post-traumatic stress disorder. It has been postulated that PNES are essentially dissociations that operate as a defensive psychological mechanism that use the mind as a defense to deal with traumas. With the advent of VEEG in the 90s, the recognition of PNES has significantly increased, and several psychological treatments have been developed. In this manuscript, we carried out a state-of-the-art review, with the aim to provide a critical approach to the extensive literature about PNES, focusing on diagnostic aspects, the primary management, and the available treatments that have been shown to be effective for the improvement of PNES.

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“…Seizure frequency was measured before and after the intervention in 17 patients, and a significant decrease in mean seizure frequency was noted. Santos et al 139 demonstrated the usefulness of psychoanalytical therapy in 37 patients. Psychoeducational 137 and mindfulness-based 140 interventions also have some evidence of usefulness.…”

Section: Psychogenic Nonepileptic Seizures (“Pseudoseizures”)mentioning

confidence: 99%

Medical management of epileptic seizures: challenges and solutions

Sarma¹,

Khandker²,

Kurczewski³

et al. 2016

NDT

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Epilepsy is one of the most common neurologic illnesses. This condition afflicts 2.9 million adults and children in the US, leading to an economic impact amounting to $15.5 billion. Despite the significant burden epilepsy places on the population, it is not very well understood. As this understanding continues to evolve, it is important for clinicians to stay up to date with the latest advances to provide the best care for patients. In the last 20 years, the US Food and Drug Administration has approved 15 new antiepileptic drugs (AEDs), with many more currently in development. Other advances have been achieved in terms of diagnostic modalities like electroencephalography technology, treatment devices like vagal nerve and deep-brain stimulators, novel alternate routes of drug administration, and improvement in surgical techniques. Specific patient populations, such as the pregnant, elderly, those with HIV/AIDS, and those with psychiatric illness, present their own unique challenges, with AED side effects, drug interactions, and medical–psychiatric comorbidities adding to the conundrum. The purpose of this article is to review the latest literature guiding the management of acute epileptic seizures, focusing on the current challenges across different practice settings, and it discusses studies in various patient populations, including the pregnant, geriatric, those with HIV/AIDS, comatose, psychiatric, and “pseudoseizure” patients, and offers possible evidence-based solutions or the expert opinion of the authors. Also included is information on newer AEDs, routes of administration, and significant AED-related drug-interaction tables. This review has tried to address only some of these issues that any practitioner who deals with the acute management of seizures may encounter. The document also highlights the numerous avenues for new research that would help practitioners optimize epilepsy management.

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Psychogenic non-epileptic seizures and psychoanalytical treatment: results

Abstract: Psychogenic non-ePilePtic seizures and Psychoanalytical treatment: results rev assoc med Bras 2014; 60(6):577-584 577

Cited by 24 publications

References 30 publications

Systematic review of psychotherapy for adults with functional neurological disorder

Systematic review of psychotherapy for adults with functional neurological disorder

Updated Review on the Diagnosis and Primary Management of Psychogenic Nonepileptic Seizure Disorders

Medical management of epileptic seizures: challenges and solutions

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