Evaluation of a new body-focused group therapy versus a guided self-help group program for adults with psychogenic non-epileptic seizures (PNES): a pilot randomized controlled feasibility study

Abstract

Objective Psychogenic non-epileptic seizures (PNES), a common phenomenon in neurological settings, are regarded as a paroxysmal type of functional neurological disorder (FND). In a substantial proportion, PNES are disabling with poor long-term outcomes and high economic costs. Despite the clinical and financial consequences of PNES, there is still a lack of controlled clinical trials on the treatment of this challenging disorder. The study aims to evaluate the feasibility and collect first evidence of the efficacy of a group based-intervention in PNES-patients. Methods A pilot randomized controlled feasibility study with a parallel-group design was performed in adult outpatients with PNES to evaluate a new body-focused group therapy (CORDIS) versus guided self-help groups. Self-assessment of dissociation (Dissociation Experience Scale—DES-20) and seizure severity (Liverpool Seizure Severity Scale—LSSS) were assessed two weeks before and two weeks after the treatment intervention and also six months after treatment as primary outcome parameters. Results A total of 53 patients were recruited from a specialized outpatient clinic, and out of those, 29 patients completed either the body-focused group therapy program (n = 15) or a guided self-help group (SHG) therapy (n = 14). When analyzing the ITT sample (n = 22 CORDIS group, n = 20 SHG), both groups showed an effect on seizure severity and level of dissociation. In the per protocol sample (n = 13 CORDIS group, n = 12 SHG), CORDIS was superior to the self-help group for reducing seizure severity 6 months after the treatment. Significance CORDIS is a newly developed body-focused group therapy program for adults with PNES. Further studies should include a multicentric design with a higher number of participants.

Group psychotherapy format guided self‐help for patients with FNSD awaiting inpatient multidisciplinary treatment: A pilot study

“…In a pilot randomised controlled feasibility study with a parallel‐group design, a sample of adult outpatients with psychogenic nonepileptic seizures (PNES) was utilised to evaluate a new body‐focussed group therapy (CORDIS) versus guided SHGs. Of the 29 patients, 15 completed the body‐focussed group therapy programme and 14 completed guided SHG therapy (Senf‐Beckenbach et al., 2022). Both groups showed changes in seizure severity and level of dissociation.…”

An update on psychogenic nonepileptic seizures

“…Illness perception and feeling understood remained improved at this point. Senf-Beckenbach et al [45] conducted a pilot randomised control study comparing a new psychotherapeutic approach to the treatment of PNES including body-focused therapy exercises (CORDIS) with an active control treatment of guided self-help group (SHG). Although both groups showed an effect on seizure severity and level of dissociation, CORDIS was superior to the SHG group for reducing seizure severity 6 months after treatment.…”