Treatment for Psychogenic Nonepileptic Seizures and Post-traumatic Stress Disorder Using Prolonged Exposure Therapy (PE) or Psychoeducation for PNES

Northeast Regional Epilepsy Group44 enrolled

Overview

An outpatient randomized controlled clinical trial conducted at the Northeast Regional Epilepsy Group's PNES Program, involving mental health clinicians certified in PE and trained in administering PsychoEd.

A randomized parallel group trial was utilized to compare two therapeutic interventions for PNES, PE or PsychoEd, both delivered remotely via teletherapy. Each psychotherapeutic modality provided 12, 90-minute sessions. Seizure frequency was the primary outcome measure. Secondary outcome measures were depression (Beck Depression Inventory) and post-traumatic stress symptomatology (Post-Traumatic Disorder Diagnostic Scale and PTSD Checklist). Data was collected prospectively, including baseline measures before initiating treatment, upon treatment completion, and at follow-up intervals of 3, 6, and 12-months post-treatment.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Psychogenic Nonepileptic Seizures (PNESs)Post Traumatic Stress Disorder PTSD

Interventions

imaginal and in vivo exposureBEHAVIORAL

Prolonged exposure is a form of cognitive behavioral treatment that uses exposure to avoided memories and reminders

psychoeducation for psychogenic nonepileptic seizuresBEHAVIORAL

A combination of psychoeducation about PNES and skills for emotional regulation and relaxation.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: English-speaking adults (18 years and older) Confirmed diagnosis of PNES through video-EEG monitoring Confirmed diagnosis of current PTSD At least one psychogenic non-epileptic seizure in the month prior to beginning treatment. Exclusion Criteria: Concurrent mixed epilepsy and PNES or video EEG findings that cannot clearly distinguish epilepsy and PNES Active suicidality Active psychotic symptoms Active substance or alcohol use or dependence that could interfere with participation in therapy Application for disability \-

Locations (1)

Northeast Regional Epilepsy Group

New York, New York, United States

Outcomes

Primary Outcomes

Nonepileptic seizure frequency

frequency of nonepileptic seizures (PNES) per month

Time frame: From enrollment until session 12 and at 3, 6 and 12month follow up

Secondary Outcomes

Beck Depression Inventory (BDI)

Self-report inventory of depressive symptoms 0-13: minimal depression, 14-19: mild, 20-28: moderate, 29-63: severe

Time frame: From enrollment to session 12 and at 3, 6 and 12 months follow up

Posttraumatic Stress Disorder Checklist (PCL) for DSM 5

Post traumatic stress symptom checklist scores range from 0-80, higher score means worse outcome

Time frame: From enrollment until session 12 of treatment and at 3, 6 and 12 months follow up

Posttraumatic Diagnostic Scale

post traumatic diagnostic scale 0: No symptoms, 1-10: Mild symptoms, 11-20: Moderate symptoms, 21-35: Moderate to severe symptoms, \>36: Severe symptoms.

Time frame: From enrollment until session 12 of treatment and at 3, 6 and 12 months follow up

Clinician Administered PTSD Scale for DSM 5 (CAPS)

Clinician-Administered PTSD Scale for DSM 5. Severity rating: 0: absent, 1: mild, 2: moderate, 3: severe, 4: extreme

Time frame: From enrollment through session 12 of treatment and at 3, 6 and 12 months follow up

Data from ClinicalTrials.gov

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