| dc.description.abstract | Background: Psychogenic nonepileptic seizures (PNES) are attacks that often
look like epileptic seizures (ES). Unlike ES, PNES are not triggered by underlying
neurological factors. PNES are relatively rare in the general population;
however, their prevalence in people with learning disabilities is much higher—
up to 10%. Individuals with PNES and learning disabilities often have psychiatric
comorbidities, such as anxiety disorders, depression and posttraumatic stress
disorder. There are currently no treatment guidelines for PNES in people with or
without learning disabilities. However, talking therapies, such as cognitive‐
behavioural therapy (CBT), are recommended. This study explores the
effectiveness of CBT for the treatment of PNES in a woman (Susan) with PNES
and learning disabilities.
Methods: We used a single‐case experimental design (SCED) to investigate the
effectiveness of CBT intervention. Specifically, the withdrawal (also known as ABA)
design was applied. The patient's average PNES frequency, as well as idiosyncratic
mood measure and standardised outcome measures for people with learning
disabilities (Glasgow Anxiety Scale for People with an Intellectual Disability and
Mini‐Maslow Assessment of Needs Scale‐Learning Disabilities), were used to assess
the effectiveness of treatment.
Findings: Results show that Susan's monthly PNES frequency reduced from phase
A1 (assessment phase) to phase B (treatment phase), and this persisted to the follow‐
up phase (phase A2). However, the reduction was not statistically significant. The
intervention was associated with improvements in Susan's mood, anxiety and quality
of life. Reduction of Susan's anxiety was clinically significant.
Conclusions: This SCED study demonstrates that CBT might be associated with
reduction of PNES frequency and improvements in general functioning in people
with PNES and learning disabilities; however, further research, especially around
confounding variables is needed. | en |