title: An evaluation of cognitive behavioral therapy as a treatment for dissociative seizures: a pilot study.
abstract: OBJECTIVE
  To evaluate in an open trial the effectiveness of cognitive behavioral therapy as a treatment of adults with dissociative seizures (i.e., "pseudoseizures").
  
  
  BACKGROUND
  Although suggestions have been made concerning the management of patients with dissociative seizures, no studies have previously evaluated the systematic use of cognitive behavioral therapy in the treatment of this disorder.
  
  
  METHODS
  Twenty patients diagnosed with dissociative seizures were offered treatment comprising 12 sessions of cognitive behavioral therapy. Principal outcome measures were dissociative seizure frequency and psychosocial functioning, including improvement in employment status and mood. Measures were administered before treatment, at the end of treatment, and at a 6-month follow-up.
  
  
  RESULTS
  Treatment was completed by 16 patients (questionnaire measures were not available for 4 patients who discontinued treatment). Following treatment, there was a highly significant reduction in seizure frequency and an improvement in self-rated psychosocial functioning. These improvements were maintained at the 6-month follow-up. There was also a tendency for patients to have improved their employment status between the start of treatment and the 6-month follow-up period.
  
  
  CONCLUSIONS
  In this open prospective trial, cognitive behavioral therapy was associated with a reduction in dissociative seizure frequency and an improvement in psychosocial functioning in adults with dissociative seizures.
authors.affiliation: Department of Psychology, Institute of Psychiatry, De Crespigny Park, London. l.goldstein@iop.kcl.ac.uk
authors.forename: Laura H
authors.initials: LH
authors.lastname: Goldstein
authors.forename: Alicia C
authors.initials: AC
authors.lastname: Deale
authors.forename: Sara J
authors.initials: SJ
authors.lastname: Mitchell-O'Malley
authors.forename: Brian K
authors.initials: BK
authors.lastname: Toone
authors.forename: John D C
authors.initials: JD
authors.lastname: Mellers
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy; D004213:Dissociative Disorders / Q000150:complications / Q000523:psychology / Q000628:therapy*; D004651:Employment; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D012640:Seizures / Q000523:psychology* / Q000628:therapy*; D012919:Social Behavior; D016896:Treatment Outcome