Authors :
Presenting Author: Jasmine Zhang, BS – University of Arizona College of Medicine - Phoenix
Harshita Talkad, BS – University of Arizona College of Medicine - Phoenix
James Bates, BS – University of Arizona College of Medicine - Phoenix
Naria Quazi, MD, MPH – University of Arizona College of Medicine - Phoenix
Robin Garrett, PsyD – Banner - University Medical Center Phoenix, University of Arizona College of Medicine - Phoenix
Alan Wang, MD – Banner - University Medical Center Phoenix, University of Arizona College of Medicine - Phoenix
Rationale:
Compared to patients with epilepsy, patients with psychogenic non-epileptic seizures (PNES) experience a higher burden of comorbid psychiatric disorders and are not effectively treated with the same medical therapies used for epileptic seizures (Yerdelen and Altintas, 2016). This study aims to describe the treatment efficacy and patient-centered outcomes of manualized cognitive behavioral therapy (CBT) for patients with PNES.
Methods:
We conducted a retrospective chart review of 50 patients who received CBT for PNES to determine self-reported non-epileptic seizure (NES) frequency before and after treatment. Of these patients, 31 received manualized CBT following a standardized regimen that included administration of the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Quality of Life (QOL), and Quality of Life in Epilepsy (QOLIE) questionnaires before and after treatment. Changes in symptom comorbidities (social functioning, depression, anxiety, and sleep quality) were assessed through a self-reported treatment outcome response grid completed during the patient’s last visit.
Results:
The frequency of NES events decreased significantly from baseline to post-treatment in both the full sample (p < 0.01) and those who received manualized CBT (p < 0.01). Additionally, among 15 patients for whom complete BDI, BAI, and QOLIE data were available, there was significant improvement in measures of BDI (p < 0.01), BAI (p = 0.01), QOL (p < 0.01), and the QOLIE seizure worry subscale (p < 0.01). Psychiatric comorbidities affected a high percentage of patients in the study sample, with the most common diagnoses being anxiety (94.0%), depression (62.0%), and post-traumatic stress disorder (32.0%). Among patients who completed the treatment outcome response grid and had depression, 90.0% reported improvement in depression, while 73.3% of those with anxiety reported improvement in anxiety. Among those who experienced impaired social functioning as a comorbid symptom, 89.5% reported improved functioning upon completion of CBT.