title: Predictors of 6-month and 3-year outcomes after psychological intervention for psychogenic non epileptic seizures.
abstract: OBJECTIVE
  To determine outcome and its predictors following psychological intervention in people with Psychogenic Non-Epileptic Seizures (PNES) METHODS: Prospective audit of 89 consecutive patients. PNES were recorded at baseline (initial psychology appointment), at 6 months and 3 years post the initial appointment. Six-month data was obtained by face-to-face interview, while 3-year data was obtained by contacting general practitioners and by postal survey.
  
  
  RESULTS
  Eight patients had stopped having PNES at the first appointment and were discharged. At 6-month follow up 43/81 patients (53.1%) were free of seizures. Predictors of cessation of seizures were: patient employed (OR 4.48, p=0.004), short waiting time for intervention (OR 0.94, p=0.018), the patient feeling they had some control over the seizures (OR 3.30, p=0.021), and an internal locus of control ((OR 7.46, p=0.001). Outcomes at 3 years based on patient report were available in 32/81 patients (36%). 11/32 patients reported being free of seizures. 50/65 patients were not accessing any healthcare for seizures. There were no significant predictors of either outcome among the variables collected.
  
  
  CONCLUSIONS
  Just over half of our patients reported being free of seizures following intervention. Being employed predicted good outcome, but the best predictor of being seizure free at 6 months was having an internal locus of control. This may be useful practically and requires further study. No good predictors of long-term outcome were found, possibly because of loss to follow up.
authors.affiliation: Department of Neurology, Christchurch Hospital, Christchurch 8011, New Zealand. Electronic address: roderick.duncan@cdhb.health.nz.
authors.forename: Roderick
authors.initials: R
authors.lastname: Duncan
authors.affiliation: Scottish Epilepsy Centre, St Kenneth Drive, Glasgow G51 4QD, UK.
authors.forename: James
authors.initials: J
authors.lastname: Anderson
authors.affiliation: Southern General Hospital, Glasgow G51 4TF, UK; Queen Elizabeth University Hospital, Glasgow G51 4TF, UK; University of Glasgow, Glasgow G12 8QQ, UK.
authors.forename: Breda
authors.initials: B
authors.lastname: Cullen
authors.affiliation: Southern General Hospital, Glasgow G51 4TF, UK; Queen Elizabeth University Hospital, Glasgow G51 4TF, UK.
authors.forename: Steven
authors.initials: S
authors.lastname: Meldrum
mesh_terms: D000328:Adult; D004827:Epilepsy / Q000209:etiology / Q000523:psychology / Q000534:rehabilitation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011602:Psychophysiologic Disorders / Q000150:complications* / Q000523:psychology; D011613:Psychotherapy / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Dissociative seizures; Intervention; Non-epileptic attack disorder; Outcome; Psychogenic nonepileptic seizures; Psychotherapy