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CBT for Patients with Epilepsy and Depression

A recent literature review published in Epilepsia examined the effectiveness of cognitive behavior therapy (CBT) as a treatment for depression in individuals with epilepsy (PWE). The systematic and qualitative review investigated both randomized controlled trials (RCTs), as well as case series via OVID. Databases utilized in this review included MEDLINE, PsychINFO, and the Cochrane EBM Reviews. All of the studies featured subjects with epilepsy, employed CBT, included a valid outcome measure for depression, and had been published in the English language, in a peer-reviewed journal. Two different researchers worked independently to determine if studies met the above inclusion criteria.

The researchers analyzed 14 distinct outcome papers in the literature review. These included 13 CBT trials, of which 6 were randomized controlled trials and 7 were case series. In half (3 of 6)of the RCTS, positive effects of CBT on depression were reported. A review of content revealed that the effective RCTs specifically tailored CBT to improve depression. Two of three RCTs that failed to find depression-related effects focused on improving seizure-control. This pattern was also observed in the case series investigated in this review. Overall this review suggests that CBT may be an effective treatment for depression in patients with Epilepsy. Given the small number of studies included in this review and methodological limitations, further research is warranted.

Source:

Gandy, M., Sharpe, L., & Perry , K. (2013). Cognitive behavior therapy for depression in people with epilepsy: a systematic review. Epilepsia, 54(10), 1725-34. doi: 10.1016/j.juro.2013.06.096

Terapia Cognitiva Conductal [The Many Applications of Cognitive Therapy]

Dr. Beck discusses the many different applications of cognitive behavior therapy (CBT)—and states that he never would have expected CBT to be utilized in the treatment of so many different conditions. For example, CBT can be useful in the treatment of patients with epilepsy; it can reduce the likelihood of additional heart attacks among cardiac patients; and it can help with cancer-related depression. www.beckinstitute.org/cbt-workshops

Group cognitive behavioral therapy for depressive and anxious symptoms in patients with epilepsy

A recent study published in Epilepsy & Behavior examined the effectiveness of a group cognitive behavioral therapy (GCBT) intervention for reducing symptoms of anxiety and depression in patients with epilepsy. Previous research has shown that individuals with epilepsy have higher rates of anxiety and depression symptomology than the general population; and while CBT has been shown to be effective in treating these conditions, the authors cite that such interventions are often not available to those with epilepsy.

The study sought to examine: 1) the effectiveness of GCBT for reducing symptoms of depression, anxiety, and negative automatic thoughts in patients with epilepsy, 2) whether a 10-session GCBT program can increase knowledge of CBT concepts and skills in patients with epilepsy, 3) the acceptability of GCBT to patients with epilepsy, as measured by recruitment attrition rate, number of overall sessions attended, and patient satisfaction with treatment.

Clinical psychologists and social workers were responsible for screening participants for inclusion via telephone, conducting the group sessions, and follow-up sessions with each participant. To measure symptoms and CBT knowledge the pre and post groups screening measures included: the Beck Depression Inventory II, the Beck Anxiety Inventory, the Automatic Thoughts Questionnaire, and the Cognitive Therapy Awareness Scale.

Results showed a significant improvement in patients’ mood, an increase in learned CBT skills and a high level of satisfaction with treatment. These findings indicate GCBT as a promising treatment for those with epilepsy, who suffer from symptoms of depression and/or anxiety. Some limitations were the small sample size, the lack of a control group, and the lack of data about  patients’ seizure disorders. The authors’ future research goals include assessing patients’ diagnoses, and obtaining follow up information to see the long-term effects of treatment.

Macrodimitris, S., Wershler, J., Hatfield, M., Hamilton, K., Backs-Dermott, B., Mothersill, K., Baxter, C., & Wiebe, S. (2011). Group cognitive-behavioral therapy for patients with epilepsy and comorbid depression and anxiety. Epilepsy and Behavior, 20, 1, 83-88.