Dissociative seizures are a type of non-epileptic seizures that are caused by mental or emotional processes rather than by a physical cause. The objective of this study is to evaluate the effectiveness of cognitive-behavioral therapy (CBT) with standardized medical care, as compared with standardized medical care alone.
This parallel-arm, pragmatic, multicenter, randomized, controlled trial included a total of 368 patients with dissociative seizures. The patients were randomly assigned in a 1:1 ratio to receive standard medical care alone (n=182) or standardized medical care plus CBT (n=186). The primary outcome of the study was monthly dissociative seizure frequency, along with seizure severity and bothersomeness.
At 12 months of follow-up, no significant difference in monthly dissociative seizure frequency was found between the two groups (4 seizures in CBT plus standard care group vs. 7 seizures in standard care group alone). However, seizures occurring in the CBT plus standard care group were treated as less bothersome, compared with seizures in the standard care group. The CBT plus standard medical care also resulted in a longer period of dissociative seizure freedom and a better health-related quality of life.
The research concluded that CBT plus standard medical care was associated with a significant reduction of monthly seizures, as compared with standard therapy alone, in patients with dissociative seizures.