Evidence map›Paper›PMID 35228117›Full record

Trial reportSeizure2022

Six-month outcomes of the CODES randomised controlled trial of cognitive behavioural therapy for dissociative seizures: A secondary analysis.

Laura H Goldstein, Emily J Robinson, Trudie Chalder, Markus Reuber, Nick Medford, Jon Stone, Alan Carson, Michele Moore, Sabine Landau

Registry-linked trialOpen access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Seizure, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07059325 (Accelerated, Left Prefrontal Transcranial Magnetic Stimulation for Functional Seizures; An Open-Label Exploration of Feasibility, Tolerability, and Preliminary Efficacy), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
2.8field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07059325 early_phase1recruitingnot on this mapstarted 2025, after this paper: background citation

Accelerated, Left Prefrontal Transcranial Magnetic Stimulation for Functional Seizures; An Open-Label Exploration of Feasibility, Tolerability, and Preliminary Efficacy

TypeinterventionalSponsorMedical University of South CarolinaRan2025 to 2027Enrolled30ConditionsFunctional Neurological Symptom Disorder, Functional SeizuresArmsTranscranial Magnetic Stimulation
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 19 citations in OpenAlex.

  1. Treatment of Functional Neurological Disorders.Journal of clinical neurology (Seoul, Korea) · 2026
    Review
  2. Functional neurological disorder: Practical management.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2025
    Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 6 institutions in 1 country.

Laura H GoldsteinDepartment of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, DeCrespigny Park, London SE5 8AF, UK. Electronic address: Laura.goldstein@kcl.ac.uk.
Emily J RobinsonSchool of Population Health and Environmental Sciences, King's College London, UK; Research Data and Statistics Unit, Royal Marsden Clinical Trials Unit, The Royal Marsden NHS Foundation Trust, Surrey, UK. Electronic address: emily.robinson@rmh.nhs.uk.
Trudie ChalderDepartment of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK. Electronic address: trudie.chalder@kcl.ac.uk.
Markus ReuberAcademic Neurology Unit, Royal Hallamshire Hospital, University of Sheffield, Sheffield, UK. Electronic address: m.reuber@sheffield.ac.uk.
Nick MedfordSouth London and Maudsley NHS Foundation Trust, London, UK. Electronic address: nick.medford@slam.nhs.uk.
Jon StoneCentre for Clinical Brain Sciences, University of Edinburgh, UK. Electronic address: jon.stone@ed.ac.uk.
Alan CarsonCentre for Clinical Brain Sciences, University of Edinburgh, UK. Electronic address: a.carson@ed.ac.uk.
Michele MooreCentre for Social Justice and Global Responsibility, School of Law and Social Sciences, London South Bank University, London, UK. Electronic address: EdMicheleMoore@gmail.com.
Sabine LandauDepartment of Biostatistics and Health Informatics, King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK. Electronic address: sabine.landau@kcl.ac.uk.
King's College London · GBUniversity of Edinburgh · GBLondon South Bank University · GBRoyal Hallamshire Hospital · GBRoyal Marsden NHS Foundation Trust · GBSouth London and Maudsley NHS Foundation Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe CODES Trial for adults with dissociative seizures had a predesignated 12-month post-randomisation follow-up point for outcome evaluation. We undertook an exploratory, unplanned, secondary analysis to evaluate the effectiveness of cognitive behavioural therapy plus standardised medical care (CBT+SMC) compared to SMC alone at 6 months post-randomisation, i.e., closer to the end of treatment.

methodsThe analysis of 6-month data followed our previous method of using multiple imputation and an intention-to-treat approach to analyse variables 12 months post-randomisation.

resultsThe original trial primary outcome of monthly seizure frequency showed greater benefit from CBT+SMC than SMC-alone at 6 months (at p < 0.05). Of 13 comparable previously-defined secondary outcomes, 12 showed a significant between group effect (p < 0.05) in favour of the CBT intervention at 6 months. The average effect size of the comparable previously-defined primary and secondary continuous outcomes was 0.33 at 6 months vs 0.26 at 12 months. The estimated Incidence Rate Ratio (IRR) quantifying monthly seizure reduction was IRR = 0.72 (95%CI from 0.55 to 0.93) at 6 months compared to IRR = 0.78 at 12 months.

conclusionDS-specific CBT (plus SMC) produced evidence of significant benefits at 6 months post- randomisation (around which time CBT was complete) compared to SMC alone; for the majority of these outcomes, better results following CBT (plus SMC) had previously been reported at 12 months. Our pattern of results suggests that short- and longer-term follow-ups are necessary to understand treatment effects in this disorder. Studies only providing short-term follow-up data should be interpreted with caution.

Indexed as

Cognitive Behavioral TherapyConversion DisorderAdultDissociative DisordersHumansSeizuresTreatment OutcomeCognitive behavioural therapyDissociative seizuresOutcomesRandomised controlled trial

Identifiers

PMID35228117
PMCPMC8970049
OpenAlexW4207059619

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.