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Cognitive Behavioral Therapy for Psychogenic Neurological Disorders

Hopp, Jennifer L. MD*; LaFrance, W. Curt Jr MD, MPH†,‡

doi: 10.1097/NRL.0b013e31826e8ff5
Invited Review Articles

Background: Psychogenic neurological disorders (PNDs) represent a significant problem in neurology, due to the difficulty in diagnosis and lack of effective and widely available treatment options. Treatment options for this population are limited. Preliminary evidence reveals cognitive behavioral therapy (CBT) may be useful in these disorders.

Review Summary: The types of PNDs and their presentations are summarized, and the utilization of CBT in treatment of these disorders is reviewed. Accurate and timely diagnosis of the disorders is paramount and provides direction for implementing appropriate treatment.

Conclusions: Neurologists should be familiar with the types of PNDs, clinical findings, and treatment principles of CBT. Early and accurate diagnosis may lead to improved treatment outcomes. Controlled treatment trials for this population are needed to determine efficacy. Further study of CBT in these patients may also help to elucidate the underlying etiology of these disorders by contributing to the understanding of associated psychopathology.

Departments of Psychiatry and Neurology, Brown Medical School

Division of Neuropsychiatry and Behavioral Neurology, Rhode Island Hospital, Providence, RI

*Department of Neurology, University of Maryland School of Medicine, Baltimore, MD

W.C.L. has received research grant funding from NINDS, American Epilepsy Society, Epilepsy Foundation and Siravo Foundation, editor’s royalties from Cambridge University Press for Gates and Rowan’s Nonepileptic Seizures, 3rd Edition, ©2010. J.L.H. has received research grant funding from the National Epifellows Foundation, author royalties from UpToDate for Driving and Epilepsy (2006-present).

The authors declare no conflict of interest.

Reprints: W. Curt LaFrance, Jr, MD, MPH, Rhode Island Hospital, 593 Eddy Street, Potter 3, Providence, RI 02903. E-mail:

© 2012 Lippincott Williams & Wilkins, Inc.