Authors

1 University of allameh tabatabai, tehran

2 university

Abstract

Psychogenic non-epileptic seizures (PNES) are periods of distress with sensory, psychomotor and behavioral symptoms that resemble epileptic seizures but electrophysiological correlated variations of these attacks are not commensurate to epilepsy. This disorder has a significant impact on daily-life activities and leads to poor quality of life. This study aimed to examine efficacy of intensive short-term dynamic psychotherapy (ISTDP) on improvement of psychogenic non-epileptic seizures. This study was an empirical case study with AB design. Psychogenic non-epileptic seizures were confirmed in subjects using QEEG and assessments of a neurologist and a psychiatrist. Beck depression inventory (BDI) was filled out by the subjects before and after the interventions. Eight Psychotherapy sessions with ISTDP approach were individually held once a week. Outcomes indicated that PNES disappeared. Furthermore, post-test BDI scores were significantly lower comparing to pre-test scores. Outcomes suggest that intensive short-term dynamic psychotherapy is an appropriate approach to reduce psychogenic non-epileptic seizures and it's applicable by therapists in clinical settings.

Keywords

دوانلو، حبیب. (1389). قفل گشایی ناخودآگاه ، چاپ اول ، انتشارات ارجمند، تهران.
دوانلو، حبیب. (1391). رواندرمانی پویشی کوتاه مدت و فشرده ، چاپ دوم، انتشارات ارجمند تهران.
حیدری نسب، لیلا.، خوریانیان، مهدی.، طیبی، زهرا. (1393). اثر بخشی روان درمانی پویشی کوتاه مدت فشرده بر کاهش نشانه ها و سبک های دفاعی در بیماران مبتلا به افسردگی. مطالعات روان‌شناسی بالینی، 26(14)، 143-168.
قربانی، نیما. (1382). روا‌ن‌درمانی پویشی کوتاه مدت و فشرده,چاپ چهارم، انتشارات سمت, تهران.
مبسم، سولماز.، دلاور، علی.، کرمی، ابوالفضل.، ثنایی، باقر.، و شفیع آبادی، عبدالله. (1391). مطالعات روان‌شناسی بالینی، 9(3)، 77-97.
Abbass, A. (2015). Reaching Through Resistance: Advanced Psychotherapy Techniques. Seven Leaves Press.
Abbass, A. (2006). Intensive Short–Term Dynamic Psychotherapy of Treatment–Resistant Depression: A Pilot Study. Depression and Anxiety, 23, 449–452.
Abbass, A. (2003). »The cost–effectiveness of short–term dynamic psychotherapy«. Journal of Pharmacoeconomics and Outcomes Research, 3, 535–539.
Abbass A. (2002). »Intensive short–term dynamic psychotherapy in a private psychiatric office: clinical and cost effectiveness«. American Journal of Psychotherapy, 56, 225–232.
Abbass, A., & Bechard, D. (2007). »Bringing character changes with Davanloo’s Intensive Short Term Dynamic Psychotherapy«. Ad Hoc Bulletin of Short Term Dynamic Psychotherapy, 11(2), 26–40.
Abbass, A., Campbell, S., Magee, K., & Tarzwell, R. (2009). »Intensive short–term dynamic psychotherapy to reduce rates of emergency department return visits for patients with medically unexplained symptoms: preliminary evidence from a pre–post intervention study«. Canadian Journal of Emergency Medicine, 11(6), 529–534.
Abbass, A., Kisely, S., & Kroenke, K. (2009). »Short–term psychodynamic psychotherapy for somatic disorders: systematic review and meta–analysis of clinical trials«. Psychotherapy and psychosomatics, 78, 265–274.
Abbass, A., Kisely, S. R., Town, J. M., Leichsenring, F., Driessen, E., De Maat, S., Gerber, A., Dekker, J., Rabung, S., Rusalovska, S., & Crowe, E. (2014). »Short–term psychodynamic psychotherapies for common mental disorders«. Cochrane Database of Systematic Reviews, 7. doi: 10.1002/14651858.CD004687.pub4.
Abbass A, Lovas D, & Purdy A. (2008). »Direct diagnosis and management of emotional factors in chronic headache patients«. Cephalalgia, 8, 1305–1314.
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM–5). Washington, DC: American Psychiatric Publishing.
Angus-Leppan, H. (2008). »Diagnosing epilepsy in neurology clinics: A prospective study«. Seizure, 17, 431–436.
Benbadis, S. R. (2013). »Nonepileptic behavioral disorders: diagnosis and treatment«. continium: Lifelong Learning in Neurology, 19(3, Epilepsy), 715-729.
Benbadis, S. R., Allen, H. W., & Hauser, W. A. (2000a). »An estimate of the prevalence of psychogenic non-epileptic seizures«. Seizure, 9, 280–281.
Bodde NMG, Brooks J .L, Baker G. A, Boon PAJM, Hendriksen JGM, Mulder OG, et al. ) 2009). »Psychogenic non-epileptic seizures—definition, etiology, treatment and prognostic issues: a critical review«. Seizure 18(8):543–53.
Carlson, P., & Perry, K. N. (2017). »Psychological interventions for psychogenic non-epileptic seizures: A meta-analysis«. Seizure, 45, 142-150.
Cope, S. R., Smith, J. G., King, T., & Agrawal, N. (2017). »Evaluation of a pilot innovative cognitive-behavioral therapy-based psychoeducation group treatment for functional non-epileptic attacks«. Epilepsy & Behavior, 70, 238-244.
Coughlin Della Selva, P. (2004). Intensive Short Term Dynamic Psychotherapy: Theory and Technique Synopsis. Karnac Books
Cramer, P. (2000). »Defense mechanisms in psychology today«. American Psychologist, 55, 637– 646.
Cramer, H., Haller, H., Lauche, R., & Dobos, G. (2012). »Mindfulness–based stress reduction for low back pain. A systematic review«. BMC Complementary and Alternative Medicine, 12, 162
Davanloo, H. (1990). Unlocking the unconscious: Selected papers of Habib Davanloo. New York: Wiley.
Davanloo, H. (2000). Intensive short–term dynamic psychotherapy: Selected papers of Habib Davanloo. Chichester, England: Wiley.
Duncan, R., Anderson, J., Cullen, B., & Meldrum, S. (2016). »Predictors of 6-month and 3-year outcomes after psychological intervention for psychogenic non epileptic seizures«. Seizure, 36, 22-26.
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, 74(24), 1986-1994.
Greenberg, L. S. (2002). Emotion–focused therapy. Washington, DC: American Psychological Association.
Hingray, C., Biberon, J., El-Hage, W., & de Toffol, B. (2016). »Psychogenic non-epileptic seizures (PNES)«. Revue neurologique, 172(4), 263-269.
Frederickson, J. (2013). Co-creating change: effective dynamic therapy.
Kaplan, M. J., Dwivedi, A. K., Privitera, M. D., Isaacs, K., Hughes, C., & Bowman, M. (2013). »Comparisons of childhood trauma, alexithymia, and defensive styles in patients with psychogenic non-epileptic seizures vs. epilepsy: Implications for the etiology of conversion disorder«. Journal of Psychosomatic Research, 75(2), 142–146.
LaFrance W, Benbadis S. (2006). »Avoiding the costs of unrecognized psychological nonepileptic seizures«. Neurology ;66:1620–1.
LaFrance, W. C., Baker, G. A., Duncan, R., Goldstein, L. H., & Reuber, M. (2013). »Minimum requirements for the diagnosis of psychogenic nonepileptic seizures: a staged approach«. Epilepsia, 54(11), 2005-2018.
Metin, S. Z., Ozmen, M., Metin, B., Talasman, S., Yeni, S. N., & Ozkara, C. (2013). »Treatment with group psychotherapy for chronic psychogenic nonepileptic seizures«. Epilepsy & Behavior, 28(1), 91-94.
RJ Neborsky, J ten Have-de Labije. (2012). Mastering intensive short-term dynamic psychotherapy, a roadmap to the unconscious.
Reuber, M., & Mayor, R. (2012). »Recent progress in the understanding and treatment of nonepileptic seizures«. Current opinion in psychiatry, 25(3), 244-250.
Reuber, M., Fernandez, G., Bauer, J., Helmstaedter, C., & Elger, C. E. (2002). »Diagnostic delay in psychogenic nonepileptic seizures«. Neurology, 58(3), 493–495.
Russell, L. A., Abbass, A. A., Allder, S. J., Kisely, S., Pohlmann-Eden, B., & Town, J. M. (2016). »A pilot study of reduction in healthcare costs following the application of intensive short-term dynamic psychotherapy for psychogenic nonepileptic seizures«. Epilepsy & Behavior, 63, 17-19.
Salinsky, M., Evrard, C., Storzbach, D., & Pugh, M. J. (2012). »Psychiatric comorbidity in veterans with psychogenic seizures«. Epilepsy & Behavior, 25(3), 345-349.
Takasaki, K., Stransky, A. D., & Miller, G. (2016). »Psychogenic Nonepileptic Seizures: Diagnosis, Management, and Bioethics«. Pediatric neurology, 62, 3-8.
Town, J. M., & Driessen, E. (2013). »Emerging evidence for intensive short-term dynamic psychotherapy with personality disorders and somatic disorders«. Psychiatric Annals, 43(11), 502-507.
Wiseman, H., & Reuber, M. (2015). »New insights into psychogenic nonepileptic seizures 2011–2014«. Seizure, 29, 69-80.