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Abstract Details

Outcomes of tailored psychotherapy for dissociative seizures in a developing functional neurology service
Aging, Dementia, Cognitive, and Behavioral Neurology
P6 - Poster Session 6 (5:30 PM-6:30 PM)
Dissociative seizures (DS) can cause distress and disability comparable to that caused by epileptic seizures. There is a growing body of evidence to suggest that psychological therapy can be effective in treating DS although the treatment approaches are varied. 
To demonstrate the effectiveness of tailored psychotherapy for patients with dissociative seizures in a clinical setting.
Here we present outcome data from a developing functional neurological disorders service in the North West of England, offering short term psychotherapy to consecutive eligible patients with a diagnosis of DS.  Patients were assessed for clinical and psychological variables before and after psychotherapy using the GAD-7 screening score for generalised anxiety disorder, the Work and Social Adjustment Scale (WSAS) to assess functional status, the PHQ-15 somatic symptoms scale, PHQ-9 depression score and PCLC PTSD symptom score.
86 patients (67 female) were referred for psychotherapy with a clinical diagnosis of DS. The mean number of therapy sessions was 5.94 (95% CI 5.04 to 6.84).  Patients had significant improvements in GAD-7 sumscores (Z=-2.549, p=0.011), PHQ-15 (p=0.028), PHQ-9 (Z=-3.202, p<0.001) as well as PCLC PTSD symptom scores (Z=-2.288, p=0.022), comparing pre and post treatment values.  Whilst there was a reduction in the median WSAS scores comparing pre and post treatment values (30 to 22.5), this difference was not significant (Z=-1.932, p=0.053).   DS frequency improved in 67.4% of patients (95% CI 52.0% to 80.5%).
Although this is an observational study, our findings support the notion that tailored psychotherapy is a clinically effective intervention to improve psychological status, quality of life and dissociative seizure frequency in a real-world clinical setting.  Further work is currently underway to assess outcomes over a longer duration to ascertain whether our findings are reproducible and the benefits are sustained.
James W. Mitchell, MBChB
Dr. Mitchell has received research support from University of Liverpool. Dr. Mitchell has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant and Research Fellow with ICHOM.
No disclosure on file
No disclosure on file
No disclosure on file
Christine E. Burness, MD, MB, ChB, MR, CP (The Walton Centre Foundation Trust) Dr. Burness has nothing to disclose.