Psychological Interventions for Psychogenic Non-epileptic Seizures: A Meta-analysis

Abstract

Introduction and objective

Psychological interventions for psychogenic non-epileptic seizures (PNES) show promising results. The aim of this meta-analysis is to evaluate and synthesize the available evidence from the previous 20 years regarding the utility of psychological interventions in the management of PNES.

Method

Studies were retrieved from MEDLINE via OvidSP and PsychINFO. Selection criteria included controlled and before-after non-controlled studies including case series, using seizure frequency as an outcome measurement. Studies were required to assess one or more types of psychological intervention for the treatment of PNES in adults. Data from 13 eligible studies was pooled to examine the effectiveness of psychological interventions in treating PNES on two primary outcomes: seizure reduction of ≥ 50% and seizure freedom. A meta-analysis was conducted with data extracted from 228 participants with PNES.

Results

Interventions reviewed in the analysis included CBT, psychodynamic therapy, paradoxical intention therapy, mindfulness, psychoeducation and eclectic interventions. Meta-analysis synthesized data from 13 studies with a total of 228 participants with PNES, of varied gender and age. Results showed 82% of people with PNES who complete psychotherapy experience a reduction in seizures of ≥50%. Additional meta-analysis synthesized data from 10 studies with a total of 137 participants with PNES. This analysis found 47% of people with PNES are seizure free upon completion of a psychological intervention.

Conclusion

The studies identified were diverse in nature and quality. Findings highlight the potential for psychological interventions as a favorable alternative to the current lack of treatment options offered to people with PNES.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.