Can mindfulness-based cognitive therapy reduce seizure activity in people with epilepsy? 公开
Bailey, Heather Nicole (2016)
Abstract
Epilepsy is a common neurological disorder characterized by recurrent and unprovoked seizures. Physical and psychological comorbidities regularly accompany chronic epilepsy, with psychological comorbidities often considered the most debilitating. Prominent among these comorbidities is depression. Persons with epilepsy show higher levels of depression than the general population, with an estimated prevalence between 32% and 48%. Project UPLIFT is a home-based intervention program designed to treat comorbid depression in people with epilepsy. It is a collaboration between the Centers for Disease Control and Prevention and the Emory University Rollins School of Public Health. The program delivers mindfulness-based cognitive therapy to patients by web and telephone. These methods of distance delivery allow the program to target hard-to-reach populations that may have limited access to mental health care. For example, persons with epilepsy are often limited by social and vocational restrictions, and they may depend on others for transportation. In randomized controlled trials, the intervention group showed a significant reduction in depressive symptoms compared to the treatment-as-usual group. The recommended treatment for depression among people with epilepsy parallels that of other depressed persons: medication, psychotherapy, or their combination. Both antidepressant medications and cognitive-behavioral therapies show efficacy for treating depression in epilepsy. Of interest, however, is the finding of limited studies that these treatments also reduce seizure activity. The current study investigates the associations between Project UPLIFT and self-reported seizure activity in people with epilepsy. After IRB review and informed consent were attained, persons with epilepsy completed the survey instrument, which included questions about demographics, depressive symptoms, health-related quality of life, and seizure activity. Participation in Project UPLIFT was not associated with a reduction in seizure activity over time (seizure severity: F [1,146] = 0.19, p = 0.6634; seizure frequency: F [1,144] = 0.28, p = 0.5985). However, both measures showed decline in the intervention group. Combined with the limited evidence base, these findings support the need for further research into the effect of psychotherapies on seizure activity. Given the harsh potential side effects of antiepileptic drugs and antidepressants, this research provides valuable insight into the concurrent and potentially convergent treatment of depression and epilepsy.
Table of Contents
Table of Contents Background………………………………………………………………………………..1
Introduction………………………………………………………………………………...........................15
Materials and Methods……………………………………………….…………...................................17
Results……………………………………………………………………………..………...........................24
Discussion………………………………………………………………………………..............................28
Tables and Figures....………………………………..……………………………..................................32
References cited………………………………………………………………………................................36
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