Research Article
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The Effect of Cognitive Behavioral Therapy on Cognitive Errors in Functional Neurological Symptom Disorder

Year 2021, Volume 4, Issue 1, 20 - 27, 30.04.2021
https://doi.org/10.33713/egetbd.817732

Abstract

Objective: Our aim is to compare the effects of pharmacotherapy (PT) and the combination of PT and cognitive behavioral therapy (CBT) on cognitive errors in patients diagnosed with functional neurological symptom disorder (FNSD). Material and Method: In this prospective study, FNSD diagnosis was made according to DSM-5. Subtypes were determined by evaluating the clinical and somatoform dissociation questionnaire (SDQ) together. Cognitive errors were evaluated with the cognitive distortions scale (CDS), and the general condition of the patient was evaluated with the global assessment scale (GAS). Results: The PT group consisted of 37 patients, and the PT+CBT group consisted of 20 patients. There was no significant difference between the groups in terms of mean age (p=0.312) and mean duration of education (p=0.345). Before the treatment, there was no significant difference between the groups in terms of CDS-IP (p=0.085), CDS-PA (p=0.145), SDQ (p=0.132) and GAS (p=0.421). Significant differences were found in both PT (p=0.011) and PT+CBT (p<0.001) groups in terms of CDS-IP values before and after treatment. While there was no significant difference between PT group before and after treatment in terms of CDS-PA (p=0.101), there was a significant difference in the PT+CBT group (p=0.048). According to the post-treatment values, there was a significant difference between the groups in terms of GAS (p=0.001) and CDS-IP (p<0.001). Conclusion: This study is important as it shows that CBT reduces cognitive errors associated with interpersonal relationships (IP). This significant change was not detected in cognitive errors associated with personal achievement (PA). Combination of CBT with drug therapy is more effective in reducing cognitive errors.

References

  • 1. Karadag AS, Kalenderoglu A, Orum MH. Optical coherence tomography findings in conversion disorder: are there any differences in the etiopathogenesis of subtypes? Arch Clin Psychiatry. 2018;45(6):154-60.
  • 2. Perez DL, Barsky AJ, Daffner K, Silbersweig DA. Motor and somatosensory conversion disorder: a functional unawareness syndrome? J Neuropsychiatry Clin Neurosci. 2012;24(2):141-51.
  • 3. Boeckle M, Liegl G, Jank R, Pieh C. Neural correlates of conversion disorder: overview and meta-analysis of neuroimaging studies on motor conversion disorder. BMC Psychiatry. 2016;16:195.
  • 4. Hingray C, Biberon J, El-Hage W, De Toffol B. Psychogenic non-epileptic seizures (PNES). Rev Neurol (Paris). 2016;172(4-5):263-9.
  • 5. Tsui P, Deptula A, Yuan DY. Conversion disorder, functional neurological symptom disorder, and chronic pain: comorbidity, assessment, and treatment. Curr Pain Headache Rep. 2017;21(6):29.
  • 6. Leary PM. Conversion disorder. Handb Clin Neurol. 2013;112:883-7.
  • 7. O'Neal MA, Baslet G. Treatment for patients with a functional neurological disorder (conversion disorder): an integrated approach. Am J Psychiatry. 2018;175(4):307-14.
  • 8. Butler AC, Chapman JE, Forman EM, Beck AT. The empirical status of cognitive-behavioral therapy: a review of meta-analyses. Clin Psychol Rev. 2006;26(1):17-31.
  • 9. Kozlowska K, Palmer DM, Brown KJ, Scher S, Chudleigh C, Davies F, Williams LM. Conversion disorder in children and adolescents: a disorder of cognitive control. J Neuropsychol. 2015;9(1):87-108.
  • 10. American Psychiatric Association. (2013). Diagnostic And Statistical Manual Of Mental Disorders, Fifth Edition (DSM-5). Arlington, VA: APP.
  • 11. Nijenhuis ERS, Spinhoven P, Van Dyck R, Van Der Hart O, Vanderlinden J. the development and psychometric characteristics of the somatoform dissociation questionnaire (SDQ-20). J Nerv Ment Dis. 1996;184(11):688-94.
  • 12. Sar V, Kundakçι, T, Kιzιltan E, Bakim B, Bozkurt O. Differentiating dissociative disorders from other diagnostic groups through somatoform dissociation in Turkey. J Trauma Dissociation. 2000;1(4):67-80.
  • 13. Özdel K, Taymur I, Guriz SO, Tulaci RG, Kuru E, Turkcapar MH. Measuring cognitive errors using the cognitive distortions scale (CDS): Psychometric properties in clinical and non-clinical samples. Plos ONE. 2014;9(8):E105956.
  • 14. Endicott J, Spitzer RL, Psychiatric Rating Scales. In Comprehensive Textbook Of Psychiatry, 5th Ed.; Kaplan HI, Sadock BJ Eds.; Williams & Wilkins: Baltimore, Maryland: 1989; pp. 2391-09.
  • 15. Waller E, Scheidt CE. Somatoform disorders as disorders of affect regulation: A study comparing the tas-20 with non-self-report measures of alexithymia. J Psychosom Res. 2004;57:239-47.
  • 16. Voon V, Lang AE. Antidepressant treatment outcomes of psychogenic movement disorder. J Clin Psychiatry. 2005;66:1529-34.
  • 17. Sharpe M, Walker J, Williams C, Stone J, Cavanagh J, Murray G, et al. Guided self-help for functional (psychogenic) symptoms: a randomized controlled efficacy trial. Neurology. 2011;77:564-72.
  • 18. Lafrance WC Jr, Baird GL, Barry JJ, Blum AS, Webb AF, Keitner GI, et al. Multicenter pilot treatment trial for psychogenic nonepileptic seizures: a randomized clinical trial. JAMA Psychiatry. 2014;71:997-1005.
  • 19. Örüm MH. The relationship between cognitive errors and psychiatric symptoms in obsessive-compulsive disorder. Med J Ankara Tr Res Hosp. 2020;53(1):29-35.
  • 20. Orum MH. Investigation of the relationship between cannabis use, opioid use and cognitive errors. Medicine Science. 2020;9(2):362-9.
  • 21. Örüm MH. Cognitive error characteristics of rumination and cleaning dimensions of obsessive-compulsive disorder. Anadolu Psikiyatri Derg. 2020;21(6):592-9.
  • 22. Örüm MH, Kara MZ, Kuştepe A, Kalenderoğlu A. Bilişsel hatalar ve dikkat-eksikliği hiperaktivite bozukluğu belirtilerinin madde kullanım özellikleri ile ilişkisi. Bağımlılık Dergisi–Journal Of Dependence. 2019;20(2):47-60.
  • 23. Rachman S. The evolution of behaviour therapy and cognitive behaviour therapy. Behav Res Ther. 2015;64:1-8.

Fonksiyonel Nörolojik Semptom Bozukluğunda Bilişsel Davranışçı Tedavinin Bilişsel Hatalar Üzerine Etkisi

Year 2021, Volume 4, Issue 1, 20 - 27, 30.04.2021
https://doi.org/10.33713/egetbd.817732

Abstract

Amaç: Amacımız fonksiyonel nörolojik semptom bozukluğu (FNSD) tanılı hastalarda farmakoterapi (FT) ve FT ile bilişsel davranışçı tedavi (BDT) kombinasyonunun bilişsel hatalar üzerine etkisini karşılaştırmaktır. Gereç ve Yöntem: Bu ileriye yönelik çalışmada FNSD tanısı DSM-5’e göre konuldu. Alt tipler klinik ve somatoform dissosiyasyon ölçeği (SDÖ)’nin birlikte değerlendirilmesiyle belirlendi. Bilişsel hatalar düşünce özellikleri ölçeği (DÖÖ) ile, hastanın genel durumu global değerlendirme ölçeği (GAS) ile değerlendirildi. Bulgular: FT grubu 37 hastadan, FT+BDT grubu 20 hastadan oluşuyordu. Gruplar arasında ortalama yaş (p=0,312), ortalama eğitim süresi (p=0,345) açısından anlamlı farklılık saptanmadı. Tedavi öncesinde, DÖÖ-IP (p=0,085), DÖÖ-PA (p=0,145), SDÖ (p=0,132) ve GAS (p=0,421) açısından gruplar arasında anlamlı farklılık saptanmadı. Hem FT (p=0,011), hem de FT+BDT (p<0,001) grubunda DÖÖ-IP açısından tedavi öncesi ve sonrası değerler açısından anlamlı farklılık ortaya çıktı. DÖÖ-PA açısından FT grubundan tedavi öncesi ve sonrası arasında anlamlı farklılık saptanmazken (p=0,101); FT+BDT grubunda anlamlı farklılık saptandı (p=0,048). Tedavi sonrası değerlere göre, gruplar arasında GAS (p=0,001) ve DÖÖ-IP (p<0,001) açısından anlamlı farklılık ortaya çıktı. Sonuç: Bu çalışma, BDT'nin kişilerarası ilişkilerle (IP) ilişkili bilişsel hataları azalttığını göstermesi açısından önemlidir. Bu anlamlı değişiklik kişisel başarı (PA) ile ilişkili bilişsel hatalarda saptanmadı. BDT'nin ilaç tedavisiyle kombinasyonu bilişsel hataları azaltmada daha etkilidir.

References

  • 1. Karadag AS, Kalenderoglu A, Orum MH. Optical coherence tomography findings in conversion disorder: are there any differences in the etiopathogenesis of subtypes? Arch Clin Psychiatry. 2018;45(6):154-60.
  • 2. Perez DL, Barsky AJ, Daffner K, Silbersweig DA. Motor and somatosensory conversion disorder: a functional unawareness syndrome? J Neuropsychiatry Clin Neurosci. 2012;24(2):141-51.
  • 3. Boeckle M, Liegl G, Jank R, Pieh C. Neural correlates of conversion disorder: overview and meta-analysis of neuroimaging studies on motor conversion disorder. BMC Psychiatry. 2016;16:195.
  • 4. Hingray C, Biberon J, El-Hage W, De Toffol B. Psychogenic non-epileptic seizures (PNES). Rev Neurol (Paris). 2016;172(4-5):263-9.
  • 5. Tsui P, Deptula A, Yuan DY. Conversion disorder, functional neurological symptom disorder, and chronic pain: comorbidity, assessment, and treatment. Curr Pain Headache Rep. 2017;21(6):29.
  • 6. Leary PM. Conversion disorder. Handb Clin Neurol. 2013;112:883-7.
  • 7. O'Neal MA, Baslet G. Treatment for patients with a functional neurological disorder (conversion disorder): an integrated approach. Am J Psychiatry. 2018;175(4):307-14.
  • 8. Butler AC, Chapman JE, Forman EM, Beck AT. The empirical status of cognitive-behavioral therapy: a review of meta-analyses. Clin Psychol Rev. 2006;26(1):17-31.
  • 9. Kozlowska K, Palmer DM, Brown KJ, Scher S, Chudleigh C, Davies F, Williams LM. Conversion disorder in children and adolescents: a disorder of cognitive control. J Neuropsychol. 2015;9(1):87-108.
  • 10. American Psychiatric Association. (2013). Diagnostic And Statistical Manual Of Mental Disorders, Fifth Edition (DSM-5). Arlington, VA: APP.
  • 11. Nijenhuis ERS, Spinhoven P, Van Dyck R, Van Der Hart O, Vanderlinden J. the development and psychometric characteristics of the somatoform dissociation questionnaire (SDQ-20). J Nerv Ment Dis. 1996;184(11):688-94.
  • 12. Sar V, Kundakçι, T, Kιzιltan E, Bakim B, Bozkurt O. Differentiating dissociative disorders from other diagnostic groups through somatoform dissociation in Turkey. J Trauma Dissociation. 2000;1(4):67-80.
  • 13. Özdel K, Taymur I, Guriz SO, Tulaci RG, Kuru E, Turkcapar MH. Measuring cognitive errors using the cognitive distortions scale (CDS): Psychometric properties in clinical and non-clinical samples. Plos ONE. 2014;9(8):E105956.
  • 14. Endicott J, Spitzer RL, Psychiatric Rating Scales. In Comprehensive Textbook Of Psychiatry, 5th Ed.; Kaplan HI, Sadock BJ Eds.; Williams & Wilkins: Baltimore, Maryland: 1989; pp. 2391-09.
  • 15. Waller E, Scheidt CE. Somatoform disorders as disorders of affect regulation: A study comparing the tas-20 with non-self-report measures of alexithymia. J Psychosom Res. 2004;57:239-47.
  • 16. Voon V, Lang AE. Antidepressant treatment outcomes of psychogenic movement disorder. J Clin Psychiatry. 2005;66:1529-34.
  • 17. Sharpe M, Walker J, Williams C, Stone J, Cavanagh J, Murray G, et al. Guided self-help for functional (psychogenic) symptoms: a randomized controlled efficacy trial. Neurology. 2011;77:564-72.
  • 18. Lafrance WC Jr, Baird GL, Barry JJ, Blum AS, Webb AF, Keitner GI, et al. Multicenter pilot treatment trial for psychogenic nonepileptic seizures: a randomized clinical trial. JAMA Psychiatry. 2014;71:997-1005.
  • 19. Örüm MH. The relationship between cognitive errors and psychiatric symptoms in obsessive-compulsive disorder. Med J Ankara Tr Res Hosp. 2020;53(1):29-35.
  • 20. Orum MH. Investigation of the relationship between cannabis use, opioid use and cognitive errors. Medicine Science. 2020;9(2):362-9.
  • 21. Örüm MH. Cognitive error characteristics of rumination and cleaning dimensions of obsessive-compulsive disorder. Anadolu Psikiyatri Derg. 2020;21(6):592-9.
  • 22. Örüm MH, Kara MZ, Kuştepe A, Kalenderoğlu A. Bilişsel hatalar ve dikkat-eksikliği hiperaktivite bozukluğu belirtilerinin madde kullanım özellikleri ile ilişkisi. Bağımlılık Dergisi–Journal Of Dependence. 2019;20(2):47-60.
  • 23. Rachman S. The evolution of behaviour therapy and cognitive behaviour therapy. Behav Res Ther. 2015;64:1-8.

Details

Primary Language Turkish
Subjects Medicine
Journal Section Original Investigation
Authors

Mehmet Hamdi ÖRÜM (Primary Author)
Elazığ Ruh Sağlığı ve Hastalıkları Hastanesi, Elazığ, Türkiye
0000-0002-4154-0738
Türkiye

Publication Date April 30, 2021
Published in Issue Year 2021, Volume 4, Issue 1

Cite

Bibtex @research article { egetbd817732, journal = {Ege Tıp Bilimleri Dergisi}, issn = {2636-851X}, address = {}, publisher = {Uşak Cerrahi Derneği}, year = {2021}, volume = {4}, pages = {20 - 27}, doi = {10.33713/egetbd.817732}, title = {Fonksiyonel Nörolojik Semptom Bozukluğunda Bilişsel Davranışçı Tedavinin Bilişsel Hatalar Üzerine Etkisi}, key = {cite}, author = {Örüm, Mehmet Hamdi} }
APA Örüm, M. H. (2021). Fonksiyonel Nörolojik Semptom Bozukluğunda Bilişsel Davranışçı Tedavinin Bilişsel Hatalar Üzerine Etkisi . Ege Tıp Bilimleri Dergisi , 4 (1) , 20-27 . DOI: 10.33713/egetbd.817732
MLA Örüm, M. H. "Fonksiyonel Nörolojik Semptom Bozukluğunda Bilişsel Davranışçı Tedavinin Bilişsel Hatalar Üzerine Etkisi" . Ege Tıp Bilimleri Dergisi 4 (2021 ): 20-27 <https://dergipark.org.tr/en/pub/egetbd/issue/62187/817732>
Chicago Örüm, M. H. "Fonksiyonel Nörolojik Semptom Bozukluğunda Bilişsel Davranışçı Tedavinin Bilişsel Hatalar Üzerine Etkisi". Ege Tıp Bilimleri Dergisi 4 (2021 ): 20-27
RIS TY - JOUR T1 - Fonksiyonel Nörolojik Semptom Bozukluğunda Bilişsel Davranışçı Tedavinin Bilişsel Hatalar Üzerine Etkisi AU - Mehmet Hamdi Örüm Y1 - 2021 PY - 2021 N1 - doi: 10.33713/egetbd.817732 DO - 10.33713/egetbd.817732 T2 - Ege Tıp Bilimleri Dergisi JF - Journal JO - JOR SP - 20 EP - 27 VL - 4 IS - 1 SN - 2636-851X- M3 - doi: 10.33713/egetbd.817732 UR - https://doi.org/10.33713/egetbd.817732 Y2 - 2021 ER -
EndNote %0 Aegean Journal of Medical Sciences Fonksiyonel Nörolojik Semptom Bozukluğunda Bilişsel Davranışçı Tedavinin Bilişsel Hatalar Üzerine Etkisi %A Mehmet Hamdi Örüm %T Fonksiyonel Nörolojik Semptom Bozukluğunda Bilişsel Davranışçı Tedavinin Bilişsel Hatalar Üzerine Etkisi %D 2021 %J Ege Tıp Bilimleri Dergisi %P 2636-851X- %V 4 %N 1 %R doi: 10.33713/egetbd.817732 %U 10.33713/egetbd.817732
ISNAD Örüm, Mehmet Hamdi . "Fonksiyonel Nörolojik Semptom Bozukluğunda Bilişsel Davranışçı Tedavinin Bilişsel Hatalar Üzerine Etkisi". Ege Tıp Bilimleri Dergisi 4 / 1 (April 2021): 20-27 . https://doi.org/10.33713/egetbd.817732
AMA Örüm M. H. Fonksiyonel Nörolojik Semptom Bozukluğunda Bilişsel Davranışçı Tedavinin Bilişsel Hatalar Üzerine Etkisi. AEGEAN J MED SCI. 2021; 4(1): 20-27.
Vancouver Örüm M. H. Fonksiyonel Nörolojik Semptom Bozukluğunda Bilişsel Davranışçı Tedavinin Bilişsel Hatalar Üzerine Etkisi. Ege Tıp Bilimleri Dergisi. 2021; 4(1): 20-27.
IEEE M. H. Örüm , "Fonksiyonel Nörolojik Semptom Bozukluğunda Bilişsel Davranışçı Tedavinin Bilişsel Hatalar Üzerine Etkisi", Ege Tıp Bilimleri Dergisi, vol. 4, no. 1, pp. 20-27, Apr. 2021, doi:10.33713/egetbd.817732

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