Behavior therapy in dissociative convulsions disorder

Abstract

Objective: To compare the remission in symptoms achieved with behavior therapy and routine clinical care to that with routine clinical care given alone to patients having dissociative disorder.

Design: A randomized controlled trial.

Place and duration of study: Psychiatry Unit, Lady Reading Hospital, Peshawar from April 2004 to September 2004.

Subjects and methods: A total sample of 100 patients was recruited through Psychiatric OPD and Emergency unit. Patients were randomly allocated to the intervention or control group. The number of fits were recorded each day during admission. The patients were followed-up for four weeks after discharge. Hospital anxiety and depression scale and clinical global impression scales were applied. The two-sample Kolmogorov-Smirnov test was used to show the differences in relative frequencies of fits between the two groups.

Results: There were no statistically significant differences in sociodemographic and clinical variables in the intervention and control groups at baseline. There was a highly significant difference between the two groups in frequency of fits at discharge, on the first follow-up and on the fourth follow-up (p=0.000). Similarly, patients in the intervention group showed more improvement on hospital anxiety and depression scale compared to the control group, (p=0.000) at the end of four weeks.

Conclusion: Behavioral intervention in the management of conversion disorder is more effective than the methods applied in our daily practice.