title: A pilot study of reduction in healthcare costs following the application of intensive short-term dynamic psychotherapy for psychogenic nonepileptic seizures.
abstract: The purpose of this study was to examine preliminary evidence of intensive short-term dynamic psychotherapy (ISTDP) as a treatment option for psychogenic nonepileptic seizures (PNES) in terms of impact on healthcare costs, emotional wellbeing, and somatic symptoms.
  
  
  
  Drawn from a sample of patients treated in a tertiary psychiatric service over a nine-year period, this naturalistic pilot study compared within-group changes from pretreatment with each year up to three years posttreatment, in physician visits, physician costs, hospital admissions, and overall hospital costs.
  
  
  
  Twenty-eight patients with PNES received ISTDP with average treatment duration of 3.6 sessions. Healthcare costs significantly reduced in follow-up compared with those in baseline, with patient costs falling below the healthy population means, and reductions in healthcare costs compared with those in baseline by 88% in year one, 90% in year two, and 81% in year three. This was accompanied by significant reductions in symptoms and interpersonal problems.
  
  
  
  These preliminary findings indicate the potential for short-term and long-term healthcare savings and improvements in emotional wellbeing, for patients with PNES from the application of ISTDP. Further research evaluating the impact of ISTDP on seizure reduction and comparing this approach with control conditions is warranted.
authors.affiliation: Clinical and Community Psychology Services, Devon Partnership NHS Trust, Exeter, UK. Electronic address: leo.russell@nhs.net.
authors.forename: Leo A
authors.initials: LA
authors.lastname: Russell
authors.affiliation: Centre for Emotions and Health, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Allan A
authors.initials: AA
authors.lastname: Abbass
authors.affiliation: Re: Cognition Health, London, UK.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Allder
authors.affiliation: School of Medicine, The University of Queensland, Princess Alexandra Hospital, Woolloongabba, Australia.
authors.forename: Steve
authors.initials: S
authors.lastname: Kisely
authors.affiliation: Epilepsy Program, Division of Neurology, Dalhousie University, Halifax, Canada.
authors.forename: Bernd
authors.initials: B
authors.lastname: Pohlmann-Eden
authors.affiliation: Centre for Emotions and Health, Dalhousie University, Halifax, Nova Scotia, Canada; National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South West Peninsula, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, England.
authors.forename: Joel M
authors.initials: JM
authors.lastname: Town
mesh_terms: D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D010865:Pilot Projects; D011602:Psychophysiologic Disorders / Q000191:economics / Q000523:psychology / Q000628:therapy*; D011613:Psychotherapy / Q000191:economics* / Q000379:methods; D012640:Seizures / Q000191:economics / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome
keywords: Clinical outcomes; Economic evaluation; Intensive short-term dynamic psychotherapy; Long-term effects; Psychogenic nonepileptic seizures