Efikasi Intervensi Cognitive Behavioral Therapy untuk Kejang Non-Epileptik Psikogenik: Tinjauan Sistematis

Abstract

Latar Belakang: CIOMS dan WHO memaparkan istilah adverse event following immunization (AEFI), salah satunya kejang non-epileptik psikogenik (PNES). Prognosis PNES umumnya buruk, pilihan pengobatan sering tidak jelas dan jarang dikerjakan. Saat ini sedang dikembangkan psikoterapi sebagai tata laksana PNES, salah satunya cognitive behavioural therapy (CBT), namun hanya terdapat sedikit bukti berkaitan dengan keberhasilannya. Tujuan: Mengetahui efikasi intervensi CBT dibandingkan dengan tanpa intervensi CBT pada pasien PNES. Metode: Pencarian literatur menggunakan lima basis data, yaitu Pubmed, Cochrane, Proquest, Science Direct, dan WHO Global Research Database on COVID-19. Literatur dipilih berdasarkan kriteria eligibilitas dan kesesuaian artikel serta PICO. Terdapat 2 studi yang terpilih dan ditelaah secara kritis pada laporan ini. Hasil: Center of Evidence Based Medicine dari Oxford University digunakan untuk melakukan telaah kritis komponen validity, importance, dan applicability dari artikel Goldstein LH, et al, (2020) dan LaFrance WC, et al, (2014). Hasil telaah kritis adalah CBT dapat menurunkan frekuensi kejang sebagai gejala psikosomatik dan memperbaiki gejala psikiatrik, kualitas hidup, interaksi sosial, serta global functioning dari pasien kejang non-epileptik psikogenik. Simpulan: Cognitive behavioural therapy memiliki efikasi baik untuk menurunkan frekuensi kejang sebagai gejala psikosomatik dan memperbaiki gejala psikiatrik, kualitas hidup, interaksi sosial, serta global functioning pasien kejang non-epileptik psikogenik.   Background: CIOMS and WHO describe a term called adverse event following immunization (AEFI), among others is psychogenic non-epileptic seizure (PNES). The prognosis of PNES is generally poor; treatment options are often unclear and rarely pursued. Various studies developed psychotherapy as a treatment for PNES, among others is cognitive behavioral therapy (CBT); but there is little evidence of its success. Objective: To evaluate the efficacy of CBT intervention compared to no CBT intervention in PNES patients. Methods: Literature search was done through five databases: Pubmed, Cochrane, Proquest, Science Direct, and WHO global research database on COVID- 19. Studies were appraised with PICO based on the eligibility criteria and the suitability of the articles. Two studies were selected and critically appraised in this report. Results: Center of Evidence Based Medicine form Oxford University was used to critically appraise the validity, importance, and applicability. Studies from Goldstein LH, et al, (2020) and LaFrance WC, et al, (2014) were analyzed. The result was CBT can reduce the frequency of seizure as psychosomatic symptom and improve psychiatric symptoms, quality of life, social interactions, and global functioning of patients with PNES. Conclusion: CBT has good efficacy in reducing seizure frequency as psychosomatic symptom and improving psychiatric symptoms, quality of life, social interactions, and global functioning of patients with PNES.