BMJ Neurology Open (Feb 2024)

Reflections on the CODES trial for adults with dissociative seizures: what we found and considerations for future studies

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

DOI
https://doi.org/10.1136/bmjno-2024-000659
Journal volume & issue
Vol. 6, no. 1

Abstract

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The COgnitive behavioural therapy versus standardised medical care for adults with Dissociative non-Epileptic Seizures multicentre randomised controlled trial is the largest, fully-powered study to test the clinical and cost-effectiveness of a psychotherapeutic intervention in this population. We also explored predictors or moderators of outcomes and investigated mechanisms of change in therapy. In this current review of findings, we discuss issues related to the design of the trial and consider the study’s nested qualitative studies which were undertaken not only to shed light on the original research questions but to provide insights and recommendations for other researchers in the field of functional neurological disorder. Finally, we consider issues relating to the possible clinical application of our study findings.