February 2020
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139 Reads
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11 Citations
Psychosomatics
Objective Psychogenic non-epileptic seizures (PNES) represent one of the most sizable treatment challenges in neuropsychiatry. Although the underlying mechanism far from being understood, several interventions have been suggested. However, patients with comorbid psychiatric diagnoses and epilepsy are excluded from most intervention studies. Methods We present a within-group post vs pre-treatment study representing the retrospective clinical results of 22 patients with PNES diagnosed in the Epilepsy Center and treated in our neuropsychiatry clinic utilizing an integrative rehabilitative psychotherapy. Therapy included presenting the diagnosis, psychoeducation, seizure reduction behavioral techniques and coping with past and present stressors. Insomuch as integrative biopsychosocial psychotherapy is based on an individualized treatment protocol for each patient, treatment was individualized and case specific. Results By the end of treatment, 36% of patients had become seizure free, a further 54% achieved a major seizure reduction (reduction of more than 70%). 72% kept at least 70% seizure reduction at follow up. General assessment of functioning (GAF) scores improved from a mean of 43.09 to a mean of 72.81 at the end of treatment and 69.72 at follow up. Additionally, we present three case descriptions that emphasize the individualized nature of psychotherapeutic decisions. Conclusions Our results support the feasibility and effectiveness of biopsychosocial based integrative psychotherapy for PNES and set principles for future treatment and prospective clinical trials in the field of individualized psychotherapy.