Clinical question
How effective are psychological treatments on health-related quality of life (HRQoL) for people with epilepsy?
Bottom line
There was moderate-quality evidence that psychological and self-management interventions benefited adults with epilepsy in terms of HRQoL, emotional wellbeing and reduced fatigue. The effect was significantly better than for usual or supportive care. The majority of trials investigated psychological interventions, such as cognitive, behavioral and mindfulness-based interventions. The remaining studies focused on education, self-management and drug adherence. Few interventions focused on HRQoL in children and adolescents.
Caveat
The studies evaluated complex psychological treatments, typically applied in tertiary care settings, and involved participant groups with comparable underlying epilepsy diagnoses. However, there were differing severities of psychiatric and somatic comorbidities, and diverse cultural, ethnic and socioeconomic backgrounds. There were differences between the included studies in their stated treatment methods, goals, strategies and theoretical underpinnings. Psychologists with varying levels of experience delivered most of the treatments.
Context
While medical providers focus on minimising seizures and side effects, a primary role mental and behavioral health providers (ie, psychologists, psychiatrists and social workers) can have with individuals with epilepsy is to optimise HRQoL by providing evidence-based psychological treatments.
Cochrane Systematic Review
Michaelis R et al. Psychological treatments for people with epilepsy. Cochrane Reviews, 2017, Issue 10. Art. No.: CD012081.DOI: 10.1002/14651858. CD012081.pub2. This review contains 24 studies involving 2439 participants.
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