Outpatient CBT for Motor Functional Neurological Disorder and Other Neuropsychiatric Conditions: A Retrospective Case Comparison
Outpatient CBT for Motor Functional Neurological Disorder and Other Neuropsychiatric Conditions: A Retrospective Case Comparison
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DOI：
10.1176/appi.neuropsych.19030067
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发表时间：
2020-12-01
影响因子：
2.9
通讯作者：
David, Anthony S.
中科院分区：
文献类型：
--
作者：
O'Connell, Nicola;Watson, Gillian;David, Anthony S.
目的：运动功能性神经障碍（mFND）没有金标准治疗，并且已发现有限的证据表明认知行为疗法（CBT）在治疗该疾病中的有效性。本研究调查了在英国神经精神科门诊接受CBT的mFND患者和非mFND患者的社会人口统计学和临床特征、治疗结局和治疗退出。来自大型匿名精神病学登记的数据用于识别2006年至2016年期间在神经精神病学诊所接受门诊CBT的患者，以及患有mFND的患者（N=98）或其他神经精神疾病（ONP）（N=76，对照组）。该研究探讨了社会人口学特征，身体症状的改善，并在临床结果和三个仪器测量心理困扰，精神后遗症的脑损伤，和depression.Results的分数的变化：最常见的mFND症状是虚弱，疼痛和震颤。Logistic回归分析发现，早期退出的mFND患者与完成CBT的患者之间没有社会人口统计学差异。仅一小部分患者可获得三种仪器的CBT前后评分：mFND和ONP患者的总体评分均显示出显着改善。Logistic回归分析发现，只有一个单一的预测症状改善的mFND组：接受心理解释的症状前treatment.Conclusions：改善身体和心理功能的mFND患者和ONP患者谁是在一个专业的CBT诊所治疗相似。这项研究提供了证据表明，CBT是可行的，有效的一些患者mFND。
Objective: No gold-standard treatment exists for motor functional neurological disorder (mFND), and Limited evidence has been found for the effectiveness of cognitive-behavioral therapy (CBT) in treating the disorder. This study examined sociodemographic and clinical characteristics, treatment outcomes, and treatment dropout among patients with and without mFND who received CBT in a neuropsychiatric outpatient clinic in the United Kingdom.Methods: Data from a large anonymized psychiatric register were used to identify patients who received outpatient CBT in a neuropsychiatry clinic between 2006 and 2016 and who had either mFND (N=98) or other neuropsychiatric conditions (ONP) (N=76, control group). The study examined sociodemographic characteristics, physical symptom improvement, and changes in clinical outcome and scores on three instruments measuring psychological distress, psychiatric sequelae of brain injury, and depression.Results: The most common mFND symptoms were weakness, pain, and tremors. A logistic regression analysis found no sociodemographic differences between patients with mFND who dropped out early and those who completed CBT. Pre- and post-CBT scores on the three instruments were available for only a small subset of patients: both mFND and ONP patients showed significant improvements in overall scores. A logistic regression analysis found only a single predictor of symptom improvement in the mFND group: acceptance of a psychological explanation of symptoms prior to treatment.Conclusions: Improvements in physical and psychological functioning were similar for patients with mFND and patients with ONP who were treated in a specialist CBT clinic. This study provides evidence that CBT is feasible and effective for some patients with mFND.