Treating Psychogenic Nonepileptic Seizures With Psychotherapy Workbook Approach

W Curt LaFrance Jr MD, MPH Assistant Professor of Psychiatry and Neurology, Alpert Medical School, Brown University Director of Neuropsychiatry and Behavioral Neurology, Rhode Island Hospital Providence RI 02903-4923MedicalResearch.com Interview with:
W Curt LaFrance Jr MD, MPH
Assistant Professor of Psychiatry and Neurology,
Alpert Medical School, Brown University
Director of Neuropsychiatry and Behavioral Neurology,
Rhode Island Hospital
Providence RI 02903-4923

MedicalResearch: What are the main findings of the study?

Dr. LaFrance: Patients treated with the 12 session, 1 hour, individual psychotherapy seizure treatment workbook had significant reductions in their seizures and improvement in their comorbid symptoms, quality of life and functioning. In contrast, treatment as usual /standard medical care (TAU/SMC) showed no improvement in seizures, comorbid symptoms or other outcomes.

MedicalResearch: Were any of the findings unexpected?

Dr. LaFrance: Showing such a significant treatment effect size in the two psychotherapy treated groups (with and without sertraline) with the small sample was unexpected. The robust results are an indicator of the impact of this intervention.

MedicalResearch: What should clinicians and patients take away from your report?

Dr. LaFrance: In our research, we have worked to demystify the challenging neuropsychiatric population with Psychogenic Nonepileptic Seizures and to equip patients and clinicians with effective treatment for a disorder that has largely been avoided by mental health providers. The results show that treatment as usual / standard medical care is not helpful for Psychogenic Nonepileptic Seizures (PNES). That all of the outcomes for the TAU/SMC group showed no improvement underscores that what is being done now with supportive therapy and routine followup is not enough to help these patients.  The seizure treatment workbook is a new, targeted treatment option for clinicians that has been used successfully for Psychogenic Nonepileptic Seizures and other conversion disorders. The workbook will be published later this year.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Dr. LaFrance: Examining the impact of the workbook with other providers trained in delivering the intervention across the country will be important, as the treatment is being disseminated to other seizure centers. Many experts have noted that approaching the disorder from a combined neurologic and psychiatric perspective, with the collaboration of Neurological and Mental Health Institutes will be important for moving the field forward.

Citation:

Last Updated on July 7, 2014 by Marie Benz MD FAAD