Psychogenic non-epileptic seizure (PNES) is a common disorder that imitates epileptic seizures and has its etiological roots in psychological distress. Due to its “epileptic” similarity, it is often dealt with not only by mental health professionals but also by physicians, pediatricians and neurologists. There is a growing consensus towards the psychotherapeutic treatment of the disorder, albeit a lack of clarity in choosing a gold-standard approach. This paper seeks to serve as a compendium of different psychotherapeutic approaches and their efficacy in the management of PNES. The paper employed the search strategy by selecting the keywords: “Psychogenic Non-Epileptic Seizures (PNES) and psychosocial management”, “PNES Treatment approach”, “PNES and psychotherapy” in PUBMED, EBSCO host, PsycINFO, and SCOPUS database. Eventually, specific therapies were cross-searched with PNES for an exhaustive review. Several studies were found employing various psychotherapeutic approaches for the treatment of PNES in pilot studies, randomized controlled, or open uncontrolled trials. Cognitive Behavior Therapy was demonstrated as an efficacious treatment for PNES in a randomized controlled trial (RCT). Other approaches that were effective in ameliorating the symptoms were psychodynamic therapies or psychoeducation based group therapies. Some therapies like Novel Integrative psychotherapy, Eye Movement Desensitisation Therapy and Mindfulness-based therapies require further exploration in larger clinical trials. The findings demonstrate that psychological intervention for PNES is a promising alternative treatment approach with a need for more RCTs with a larger sample and robust methodology for better generalization.


中文翻译：

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心因性非癫痫性癫痫发作和社会心理管理：叙事回顾


心因性非癫痫性癫痫（PNES）是一种模仿癫痫性癫痫的常见疾病，其病因源于心理困扰。由于其“癫痫”的相似性，它不仅经常由精神卫生专业人员处理，而且还由医生，儿科医生和神经科医生处理。尽管在选择黄金标准方法时缺乏明确性，但人们对这种疾病的心理治疗方法已达成越来越多的共识。本文旨在作为各种心理治疗方法及其在PNES管理中的功效的纲要。该论文通过选择以下关键词来采用搜索策略：在PUBMED，EBSCO主机，PsycINFO和SCOPUS数据库中选择“心理性非癫痫发作（PNES）和社会心理管理”，“ PNES治疗方法”，“ PNES和心理治疗”。最终，对特定疗法与PNES进行了交叉搜索，以进行详尽的审查。在先导研究，随机对照或开放性非对照试验中，发现采用多种心理治疗方法治疗PNES的多项研究。在一项随机对照试验（RCT）中，认知行为疗法被证明是治疗PNES的有效方法。有效改善症状的其他方法是心理动力疗法或基于心理教育的团体疗法。一些疗法，如新型综合心理疗法，眼球运动脱敏疗法和正念疗法，需要在更大的临床试验中进一步探索。