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Cited by 477

The DOI matches its Crossref record; 90 of the 90 references it cites were found in a registry or an index.

Cognitive-behavioral therapy for psychogenic nonepileptic seizures: A pilot RCT

Open access
Goldstein, L.H., Chalder, T., Chigwedere, C., Khondoker, M.R., Moriarty, J., Toone, B.K., Mellers, J.D.C.·2010·Neurology

Abstract

OBJECTIVE: To compare cognitive-behavioral therapy (CBT) and standard medical care (SMC) as treatments for psychogenic nonepileptic seizures (PNES). METHODS: Our randomized controlled trial (RCT) compared CBT with SMC in an outpatient neuropsychiatric setting. Sixty-six PNES patients were randomized to either CBT (plus SMC) or SMC alone, scheduled to occur over 4 months. PNES diagnosis was established by video-EEG telemetry for most patients. Exclusion criteria included comorbid history of epilepsy, <2 PNES/month, and IQ <70. The primary outcome was seizure frequency at end of treatment and at 6-month follow-up. Secondary outcomes included 3 months of seizure freedom at 6-month follow-up, measures of psychosocial functioning, health service use, and employment. RESULTS: In an intention-to-treat analysis, seizure reduction following CBT was superior at treatment end (group x time interaction p < 0.0001; large to medium effect sizes). At follow-up, the CBT group tended to be more likely to have experienced 3 months of seizure freedom (odds ratio 3.125, p = 0.086). Both groups improved in some health service use measures and on the Work and Social Adjustment Scale. Mood and employment status showed no change. CONCLUSIONS: Our findings suggest that cognitive-behavioral therapy is more effective than standard medical care alone in reducing seizure frequency in PNES patients. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that CBT in addition to SMC, as compared to SMC alone, significantly reduces seizure frequency in patients with PNES (change in median monthly seizure frequency: baseline to 6 months follow-up, CBT group, 12 to 1.5; SMC alone group, 8 to 5).

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Metadata

Authors
Goldstein, L. H., Chalder, T., Chigwedere, C., Khondoker, M. R., Moriarty, J., Toone, B. K., & Mellers, J. D. C.
Venue
Neurology
Published
2010-06-15
Volume
74
Issue
24
Pages
1986-1994
ISSN
  • 0028-3878 (ISSN-L)
  • 1526-632X
OpenAlex
W2035123334
Cited by
477
References
90
FWCI
18.14
Type
journal article
Language
en
Open access
green

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CoChat. (2026). Citation check: Cognitive-behavioral therapy for psychogenic nonepileptic seizures: A pilot RCT. https://app.cochat.ai/papers/10.1212/wnl.0b013e3181e39658
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Goldstein, L. H., Chalder, T., Chigwedere, C., Khondoker, M. R., Moriarty, J., Toone, B. K., & Mellers, J. D. C. (2010). Cognitive-behavioral therapy for psychogenic nonepileptic seizures: A pilot RCT. Neurology. https://doi.org/10.1212/wnl.0b013e3181e39658

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