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

Öz

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.

Anahtar Kelimeler

• Functional neurological symptom disorder
• conversion disorder
• cognitive behavioral therapy
• cognition
• drug therapy

Fonksiyonel Nörolojik Semptom Bozukluğunda Bilişsel Davranışçı Tedavinin Bilişsel Hatalar Üzerine Etkisi

Öz

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.

Anahtar Kelimeler

• Fonksiyonel nörolojik semptom bozukluğu
• konversiyon bozukluğu
• bilişsel davranışçı tedavi
• biliş
• ilaç tedavisi

Kaynakça

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