Cognitive behavioural therapy for adults with dissociative seizures (CODES): a pragmatic, multicentre, randomised controlled trial
| العنوان: | Cognitive behavioural therapy for adults with dissociative seizures (CODES): a pragmatic, multicentre, randomised controlled trial |
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| المؤلفون: | Joanna Murray, Panayiota Petrochilos, Carole Eastwood, James Purnell, Elisa Bruno, R. Simkiss, J. Elvish, S. Memon, Jon Stone, M. Buckley, Lea Ludwig, Fergus J. Rugg-Gunn, Gerald T. Finnerty, D. Alvares, T. Andrews, M. Whittaker, L. Wicks, Iris Mosweu, MJ Edwards, T. Vick, H. Healy, N. Adab, S. Samarasekera, A. Morgan-Boon, R. Chalmers, Dilraj Sokhi, J. Vinnicombe, M. Chowdhury, M. Bennett, Daniel Blackburn, Robert D. C. Elwes, Mark Broadhurst, Susan Duncan, Paul McCrone, A. Meadow, D. Protheroe, G. Saldanha, L. Toplis, R. Armstrong, P. Pullicino, Lina Nashef, Nick Firth, D. Phoenix, W. Pickerell, C. Mitchell, Sofia H Eriksson, Christopher D. Graham, H. Allroggen, Christine Burness, C. Rowbottom, Dhara A. Patel, F. McKevitt, Jon M Dickson, A. M. Abe, Guru Kumar, H. Hunt, J. Thorpe, Hannah R. Cock, T. Pieters, Christopher P. Derry, Sarah J Feehan, Philip E. M. Smith, B Diehl, A. Shetty, Davide Martino, Mark H. Johnson, Jasvinder A. Singh, S. Eriemo, Nick Medford, Jananee Sivagnanasundaram, Iain Perdue, L. Teare, C. Hewamadduma, A. Miorelli, Daniel J. O’Hara, M. Bodani, Joanna Karlsson, G. Cocco, Stjepana Kovac, Gary Price, J. Knibb, R. Taylor, S. Harrison, M. Wickremaratchi, Michalis Koutroumanidis, R. Hadden, Melissa J Maguire, R. Fung, Richard Harding, S. Chong, Markus Reuber, I. Tylova, Gary Dennis, K. Evans, G. Jensch, Mark P. Richardson, F. Chowdury, S. Slaght, M. Innocente, R. Liu, R A Grünewald, C. Rockliffe-Fidler, N. Kock, A. Copping, Harriet Jordan, Elana Day, C. Walsh, Niruj Agrawal, Rohit Saha, K. Cikurel, Julie Read, T. Tahir, T. N. Mitchell, L. Page, Lorea Flores, S. Ellawella, A. Laker, V. Sanchez Sanchez, T. Webb, Sabine Landau, Sahran Higgins, Steven Kemp, A. Hussain, Jennifer Quirk, Norman Poole, Guy D. Leschziner, Killian A. Welch, Alice Brockington, L. Suvorova, A. McGorlick, Stephen Howell, Nandini Mullatti, Alastair M Santhouse, Manny Bagary, Heather Angus-Leppan, V. Moffitt, J. Moriarty, T. Black, K. Scholes, Hannah Callaghan, R. Faruqui, M. Baldellou Lopez, Matthew C. Walker, S. Cope, B. Ridha, Trudie Chalder, R. Devlin, M. Tsakopoulou, Biba R. Stanton, Bridget K MacDonald, C M Ellis, J. Aram, C. Donnelly, Nicholas Moran, A.R.C. Kelso, K. Weyrich, Z. Green-Thompson, Louise Oakley, Emily J. Robinson, Paula Gardiner, A. Atalaia, S. Cooper, G. Watson, Marco Mula, D. Lozsadi, S. Rajakulendran, John D. C. Mellers, S. O'Sullivan, M. Manford, Tim Wehner, Alan Carson, S. Harikrishnan, Izabela Pilecka, K. McKeown, Mahinda Yogarajah, James T. Teo, L. Tedesco, R. Delamont, Dougall McCorry, Khalid Hamandi, Laura H. Goldstein, Lindsey Macgregor, Michele Moore, Paul Shotbolt, A. Sachar |
| المصدر: | Goldstein, L H, Robinson, E J, Mellers, J D C, Stone, J, Carson, A, Reuber, M, Medford, N, McCrone, P, Murray, J, Richardson, M P, Pilecka, I, Eastwood, C, Moore, M, Mosweu, I, Perdue, I, Landau, S, Chalder, T, Abe, A M, Adab, N, Agrawal, N, Allroggen, H, Alvares, D, Andrews, T, Angus-Leppan, H, Aram, J, Armstrong, R, Atalaia, A, Bagary, M, Baldellou Lopez, M, Bennett, M, Black, T, Blackburn, D, Bodani, M, Broadhurst, M, Brockington, A, Bruno, E, Buckley, M, Burness, C, Callaghan, H, Chalmers, R, Chong, S, Chowdhury, M, Chowdury, F, Cikurel, K, Cocco, G, Cock, H, Cooper, S, Cope, S, Copping, A, Day, E, Delamont, R, Dennis, G, Derry, C, Devlin, R, Dickson, J M, Diehl, B, Donnelly, C, Duncan, S, Edwards, M, Ellawella, S, Ellis, C, Elvish, J, Elwes, R, Eriemo, S, Eriksson, S, Evans, K, Faruqui, R, Feehan, S, Finnerty, G, Flores, L, Firth, N, Fung, R, Gardiner, P, Graham, C, Green-Thompson, Z, Grunewald, R, Hadden, R, Hamandi, K, Harding, R, Harikrishnan, S, Harrison, S, Healy, H, Hewamadduma, C, Higgins, S, Howell, S, Hunt, H, Hussain, A, Innocente, M, Jensch, G, Johnson, M, Jordan, H, Karlsson, J, Kelso, A, Kemp, S, Knibb, J, Kock, N, Koutroumanidis, M, Kovac, S, Kumar, G, Laker, A, Leschziner, G, Liu, R, Lozsadi, D, Ludwig, L, MacDonald, B, MacGregor, L, Maguire, M, Manford, M, Martino, D, McCorry, D, McGorlick, A, McKeown, K, McKevitt, F, Meadow, A, Memon, S, Miorelli, A, Mitchell, C, Mitchell, T N, Moffitt, V, Moran, N, Morgan-Boon, A, Moriarty, J, Mula, M, Mullatti, N, Nashef, L, O'Hara, D, Oakley, L, O'Sullivan, S, Page, L, Patel, D, Petrochilos, P, Phoenix, D, Pickerell, W, Pieters, T, Poole, N, Price, G, Protheroe, D, Pullicino, P, Purnell, J, Quirk, J, Rajakulendran, S, Read, J, Ridha, B, Rockliffe-Fidler, C, Rowbottom, C, Rugg-Gunn, F, Sachar, A, Saha, R, Saldanha, G, Samarasekera, S, Sanchez Sanchez, V, Santhouse, A, Scholes, K, Shetty, A, Shotbolt, P, Simkiss, R, Singh, J, Sivagnanasundaram, J, Slaght, S, Smith, P, Sokhi, D, Stanton, B, Suvorova, L, Tahir, T, Taylor, R, Teare, L, Tedesco, L, Teo, J, Thorpe, J, Toplis, L, Tsakopoulou, M, Tylova, I, Vick, T, Vinnicombe, J, Walker, M, Walsh, C, Watson, G, Webb, T, Wehner, T, Welch, K, Weyrich, K, Whittaker, M, Wickremaratchi, M, Wicks, L & Yogarajah, M 2020, ' Cognitive behavioural therapy for adults with dissociative seizures (CODES) : a pragmatic, multicentre, randomised controlled trial ', The Lancet Psychiatry, vol. 7, no. 6, pp. 491-505 . https://doi.org/10.1016/S2215-0366Test(20)30128-0 2020, ' Cognitive behavioural therapy for adults with dissociative seizures (CODES): a pragmatic, multicentre, randomised controlled trial ', The Lancet Psychiatry, vol. 7, no. 6, pp. 491-505 . https://doi.org/10.1016/S2215-0366Test(20)30128-0 |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Adult, Male, Pediatrics, medicine.medical_specialty, Visual analogue scale, Population, Dissociative Disorders, Rate ratio, Severity of Illness Index, law.invention, 03 medical and health sciences, Epilepsy, 0302 clinical medicine, Quality of life, Randomized controlled trial, law, Seizures, Severity of illness, Medicine, Humans, 030212 general & internal medicine, education, Biological Psychiatry, Psychiatric Status Rating Scales, education.field_of_study, Depressive Disorder, Wales, Cognitive Behavioral Therapy, business.industry, Middle Aged, medicine.disease, 030227 psychiatry, Intention to Treat Analysis, Psychiatry and Mental health, Treatment Outcome, England, Scotland, Patient Satisfaction, RC Internal medicine, Quality of Life, Female, business, Psychosocial |
| الوصف: | Background\ud Dissociative seizures are paroxysmal events resembling epilepsy or syncope with characteristic features that allow them to be distinguished from other medical conditions. We aimed to compare the effectiveness of cognitive behavioural therapy (CBT) plus standardised medical care with standardised medical care alone for the reduction of dissociative seizure frequency.\ud \ud Methods\ud In this pragmatic, parallel-arm, multicentre randomised controlled trial, we initially recruited participants at 27 neurology or epilepsy services in England, Scotland, and Wales. Adults (≥18 years) who had dissociative seizures in the previous 8 weeks and no epileptic seizures in the previous 12 months were subsequently randomly assigned (1:1) from 17 liaison or neuropsychiatry services following psychiatric assessment, to receive standardised medical care or CBT plus standardised medical care, using a web-based system. Randomisation was stratified by neuropsychiatry or liaison psychiatry recruitment site. The trial manager, chief investigator, all treating clinicians, and patients were aware of treatment allocation, but outcome data collectors and trial statisticians were unaware of treatment allocation. Patients were followed up 6 months and 12 months after randomisation. The primary outcome was monthly dissociative seizure frequency (ie, frequency in the previous 4 weeks) assessed at 12 months. Secondary outcomes assessed at 12 months were: seizure severity (intensity) and bothersomeness; longest period of seizure freedom in the previous 6 months; complete seizure freedom in the previous 3 months; a greater than 50% reduction in seizure frequency relative to baseline; changes in dissociative seizures (rated by others); health-related quality of life; psychosocial functioning; psychiatric symptoms, psychological distress, and somatic symptom burden; and clinical impression of improvement and satisfaction. p values and statistical significance for outcomes were reported without correction for multiple comparisons as per our protocol. Primary and secondary outcomes were assessed in the intention-to-treat population with multiple imputation for missing observations. This trial is registered with the International Standard Randomised Controlled Trial registry, ISRCTN05681227, and ClinicalTrials.gov, NCT02325544.\ud \ud Findings\ud Between Jan 16, 2015, and May 31, 2017, we randomly assigned 368 patients to receive CBT plus standardised medical care (n=186) or standardised medical care alone (n=182); of whom 313 had primary outcome data at 12 months (156 [84%] of 186 patients in the CBT plus standardised medical care group and 157 [86%] of 182 patients in the standardised medical care group). At 12 months, no significant difference in monthly dissociative seizure frequency was identified between the groups (median 4 seizures [IQR 0–20] in the CBT plus standardised medical care group vs 7 seizures [1–35] in the standardised medical care group; estimated incidence rate ratio [IRR] 0·78 [95% CI 0·56–1·09]; p=0·144). Dissociative seizures were rated as less bothersome in the CBT plus standardised medical care group than the standardised medical care group (estimated mean difference −0·53 [95% CI −0·97 to −0·08]; p=0·020). The CBT plus standardised medical care group had a longer period of dissociative seizure freedom in the previous 6 months (estimated IRR 1·64 [95% CI 1·22 to 2·20]; p=0·001), reported better health-related quality of life on the EuroQoL-5 Dimensions-5 Level Health Today visual analogue scale (estimated mean difference 6·16 [95% CI 1·48 to 10·84]; p=0·010), less impairment in psychosocial functioning on the Work and Social Adjustment Scale (estimated mean difference −4·12 [95% CI −6·35 to −1·89]; p |
| وصف الملف: | text; application/pdf |
| تدمد: | 2215-0374 0568-1227 2215-0366 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::615df31f87a33d32af3acef3730970fdTest https://pubmed.ncbi.nlm.nih.gov/34025255Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....615df31f87a33d32af3acef3730970fd |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 22150374 05681227 22150366 |
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