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Goldstein LH, Stone J, Reuber M, Landau S, Robinson EJ, Carson A, Medford N, Chalder T. Reflections on the CODES trial for adults with dissociative seizures: what we found and considerations for future studies. BMJ Neurol Open 2024; 6:e000659. [PMID: 38860230 PMCID: PMC11163627 DOI: 10.1136/bmjno-2024-000659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 04/21/2024] [Indexed: 06/12/2024] Open
Abstract
The COgnitive behavioural therapy versus standardised medical care for adults with Dissociative non-Epileptic Seizures multicentre randomised controlled trial is the largest, fully-powered study to test the clinical and cost-effectiveness of a psychotherapeutic intervention in this population. We also explored predictors or moderators of outcomes and investigated mechanisms of change in therapy. In this current review of findings, we discuss issues related to the design of the trial and consider the study's nested qualitative studies which were undertaken not only to shed light on the original research questions but to provide insights and recommendations for other researchers in the field of functional neurological disorder. Finally, we consider issues relating to the possible clinical application of our study findings.
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Affiliation(s)
- Laura H Goldstein
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jon Stone
- Department of Clinical Neuroscience, Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
| | - Markus Reuber
- Academic Neurology Unit, Royal Hallamshire Hospital, The University of Sheffield, Sheffield, UK
| | - Sabine Landau
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Emily J Robinson
- School of Population Health and Environmental Sciences, King's College London, London, UK
- Research Data and Statistics Unit, Royal Marsden Clinical Trials Unit, The Royal Marsden NHS Foundation Trust, Surrey, UK
| | - Alan Carson
- Department of Clinical Neuroscience, Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
| | - Nick Medford
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Trudie Chalder
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Stigma in Functional Seizures: A Scoping Review. Seizure 2022; 99:131-152. [DOI: 10.1016/j.seizure.2022.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 05/12/2022] [Accepted: 05/18/2022] [Indexed: 11/18/2022] Open
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