Trial By Error: More Questions About CODES Trial of CBT for Seizures

By David Tuller, DrPH I have recently written about CODES, the high-profile clinical trial investigating whether cognitive behavior therapy (CBT) could reduce the frequency of dissociative seizures, also known as  psychogenic non-epileptic seizures. The trial, published by Lancet Psychiatry, was an open-label study relying on self-reported outcomes–a design highly vulnerable to bias. The 368 participants […]
Source: virology blog - Category: Virology Authors: Tags: Uncategorized CBT CODES dissociative seizures FND Jon Stone Kings College London psychogenic nonepileptic seizures Trudie Chalder Source Type: blogs

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Lancet Psychiatry recently published the results of a high-profile trial of cognitive behavior therapy as a treatment for so-called dissociative seizures, also known as psychogenic non-epileptic seizures. The trial, nicknamed CODES, found that CBT had no impact on seizure frequency–the primary outcome. The average number of seizures per month dropped in both the treatment and […]
Source: virology blog - Category: Virology Authors: Tags: Uncategorized CBT CODES irritable bowel syndrome PACE Source Type: blogs
Publication date: May 2020Source: Epilepsy &Behavior, Volume 106Author(s): Alex J. Berry, Macide Yuksel, Barnaby J. Proctor, Jacqueline Foong
Source: Epilepsy and Behavior - Category: Neurology Source Type: research
This study provides evidence that CBT can be effective in reducing depression and anxiety in patients with both epilepsy and DS. Anxiety and depression are likely to be associated with DS. Further research in larger samples and longitudinal studies are recommended to evaluate the long-term efficacy of CBT in this patient group. PMID: 32169599 [PubMed - as supplied by publisher]
Source: Epilepsy and Behaviour - Category: Neurology Authors: Tags: Epilepsy Behav Source Type: research
Conclusions: Clinical guidance around combined treatment (psychotherapy plus ADMs) should be reconsidered. CBT alone is superior to IPT alone and to combined treatment, while IPT alone is non-inferior to combined treatment. More research is needed to assess the moderating effect of older age and number of previous episodes on IPT efficacy. The Study in Context: CVS Health: Cognitive behavioral therapy (CBT) apps may help you more than sleeping pills Growing research aims at helping cancer patients in distress access most-likely-to-help self-care options, from Mindfulness training to Web-based cognitive behavioral therapy...
Source: SharpBrains - Category: Neuroscience Authors: Tags: Cognitive Neuroscience Health & Wellness cognitive behavioural therapy face-to-face therapy interpersonal psychotherapy major depression psychiatry Source Type: blogs
ConclusionFirst attendance at a psychiatry appointment after a neurologist had given a diagnosis of dissociative seizures was not associated with any hypothesised predictors, including patient confidence in the diagnosis. Neurologists should put aside any expectations about these variables when referring to and anticipating attendance with a psychiatrist.Graphical abstract
Source: Seizure - Category: Neurology Source Type: research
ConclusionsThe MBCT-S appears efficacious in enhancing sexual function and reducing sex-related distress in Iranian older adult WWE. Future studies should examine its efficacy in other populations.Trial Registration NumberThe trial was registered with the ClnicalTrials.gov database (NCT03427918).
Source: Seizure - Category: Neurology Source Type: research
ConclusionsThis study found that participating in Project UPLIFT directly reduced the number of seizures experienced by participants with epilepsy. This was not mediated by the change in depression. Participation in Project UPLIFT also reduced their perceived seizure severity indirectly, through reducing their depressive symptoms. This suggests Project UPLIFT may have the potential to impact the health, healthcare costs, and well-being of people with epilepsy.
Source: Epilepsy and Behavior - Category: Neurology Source Type: research
CONCLUSIONS: This study found that participating in Project UPLIFT directly reduced the number of seizures experienced by participants with epilepsy. This was not mediated by the change in depression. Participation in Project UPLIFT also reduced their perceived seizure severity indirectly, through reducing their depressive symptoms. This suggests Project UPLIFT may have the potential to impact the health, healthcare costs, and well-being of people with epilepsy. PMID: 31648928 [PubMed - as supplied by publisher]
Source: Epilepsy and Behaviour - Category: Neurology Authors: Tags: Epilepsy Behav Source Type: research
This study explored the acceptability and feasibility of an MBCT intervention for this group. The data suggests that this intervention could be potentially useful in improving the mental health of this population, and includes suggestions for making the intervention culturally relevant.
Source: Journal of Racial and Ethnic Health Disparities - Category: International Medicine & Public Health Source Type: research
Dissociative seizures —also referred to as psychogenic non-epileptic seizures— account for about 20% of referrals to seizure clinics [1]. Traditionally, neurologists have viewed their role as limited to the diagnosis of dissociative seizures rather than the treatment of this disorder [2]. While there is currently no clear evidence base, expert opinion has favoured psychotherapeutic treatments [3], although most patients perceive their dissociative seizures as a problem which is largely “physical” [4].
Source: Seizure: European Journal of Epilepsy - Category: Neurology Authors: Source Type: research
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