Abstracts

Patients with non-epileptic seizures (NES) are often seen in in-patient video-EEG monitoring units with a frequency of up to 40%-50% of admissions. There have been a plethora of studies investigating the diagnosis of this disorder which note the common occurrence of histories of abuse, depressive complaints, dissociative symptoms, etc. Outcome studies have noted a good prognosis in children with the disorder, but rates for adults are not as promising with only 29% to 45% who achieve seizure freedom 5 years after evaluation. Treatment strategies for patients with this disorder have been sparse, at best. The authors attempted to develop a group therapy intervention with a cohort of patients with refractory, chronic NES. In most cases, when possible, this was coupled with individual and pharmacotherapy. Eight women (n=8) participated in the group treatment for two 16 week intervals. Outcomes included the SCL-90 and frequency of seizures measured on a weekly basis. The researchers hypothesized that the scores on the SCL-90 subscales and seizure frequency would decrease as a result of the intervention. The group intervention was psychodynamic and process oriented focusing on educational, interpersonal and communication issues both in and out of the group. Regression lines were fit to each individual[rsquo]s data yielding a slope and intercept. Descriptive statistics indicated a mean reduction on ten of the twelve SCL-90 subscales. Effect sizes ranged from 0.03 to 0.92 with the most substantial reductions found on the SCL-90 obsessive compulsive (effect size= 0.92), phobic anxiety (effect size= 0.71), depression (effect size= 0.67), and the somatization (effect size= 0.31) scales. Six of the women experienced a decrease in seizure frequency over the treatment period. Overall subjective quality of life improved, in some cases dramatically. Although seizure frequencies did not decline substantially in all patients, it appeared that ongoing and unresolved emotional and psychological conflicts were present in those patients with unchanged seizure activity. The group intervention allowed patients to see the seizure activity in other patients and develop a strong emotional bond with others suffering the same illness. The group also fostered the delineation of psychological issues and provided an easy conduit into individual therapy. These preliminary data suggest that people with non-epileptic seizures could experience both a psychological benefit and a concomitant reduction in seizures from participating in group psychotherapy treatment.