CBT vs Standardised Medical Care to treat Dissociative Seizures
Research type
Research Study
Full title
COgnitive behavioural therapy vs standardised medical care for adults with Dissociative non-Epileptic Seizures: A multi-centre randomised controlled trial (CODES).
IRAS ID
136836
Contact name
Laura H. Goldstein
Contact email
Sponsor organisation
King's College London
Research summary
About 12-20% of patients attending neurology / specialist epilepsy clinics because of seizures do not have epilepsy. Most of these have what are referred to as dissociative seizures (DS). These resemble epileptic seizures but have no medical reason for their occurrence and are thought to be due to psychological factors. There is some indication that cognitive behavioural therapy (CBT) may reduce the occurrence of DS. We have developed a CBT package for people with DS and in a relatively small study where patients were allocated a random to either receive their standardised medical care (SMC) or CBT plus SMC we found that people receiving CBT overall showed greater reduction in their DS occurrence than those who only received SMC. We are now proposing a larger study across several different hospitals. Patients with DS who have been newly given their diagnosis by a neurologist or epilepsy specialist will be invited to take part in the study and to keep records of their DS. When reviewed by a psychiatrist three months later we will ask those whose DS continued in the previous 8 weeks to consent to be randomised to receive 12 sessions of CBT (+ SMC) vs SMC alone. We will follow-up patients 6- and 12 months after randomisation. We will measure treatment effectiveness in terms of reduced frequency of people’s seizures and improvement in a number of aspects of their psychological functioning. We will also measure the reduction in people’s use of health services, time lost from work and the dependence on informal care by family and friends as well as the level of financial state benefits they receive. We will also describe patients’ views of the intervention, including barriers and benefits of participation by completing in-depth interviews with ~20 from the CBT and 10 from the SMC-alone groups.
REC name
London - Camberwell St Giles Research Ethics Committee
REC reference
13/LO/1595
Date of REC Opinion
18 Dec 2013
REC opinion
Further Information Favourable Opinion