Neuropsychiatric Symptoms of Epilepsy

15 Stress and Epilepsy
275
Table 15.3 Evidence for psychobehavioral treatments including strategies for stress in epilepsy [ 126 – 141 ]
Ref No Country Epilepsy type and setting Intervention
Behavioral / cognitive behavioral approaches
[ 126 ] 8 vs. 10 vs. 9
Canada Mixed (including 2 each
group with NES), all with
significant psychosocial
problems; epilepsy clinics
[ 127 ] 6 vs. 6
vs. 6
Sweden Mixed, refractory; neurology
clinics
[ 128 ] 16 Germany Mixed, refractory; neurology
clinics
[ 129 ] 18 vs. 19 Australia Mixed, >60 years old;
community and clinics
8 × 2-h sessions of group CBT
vs. 8 2-h sessions of vs.
supportive counseling or wait
list control
6-week contingent relaxation
vs. 6-week attention control vs.
no treatment
Therapist guided psychological
intervention (“self-control
training”) over 3–30 months
6× weekly 2 h-sessions group
CBT vs. 6× 1 h relaxation
sessions
Design, primary
endpoint Results
Single blind RCT;
daily seizure diaries,
patient and physician
standard scales, 4
month follow-up
Open RCT (10 weeks
baseline and posttreatment
follow-up),
and open follow-up (all
active) up to 72 weeks
total
Prospective case series,
6 months – 3 years
follow-up, no
predefined endpoint
Open RCT Mood and
psychosocial
functioning scales,
seizure frequency, 3
month follow-up vs.
baseline
No change in any group
on seizures or
psychosocial difficulties
Median seizure
frequency 66 %↓
post-treatment vs. 2 %↓
wait list, 68 %↑
attention control
( p < 0.05 all pairs); all
improved 30 weeks post
treatment (open;
p = .001)
68 % improved (50 %
by >80 %, 18 % by
50–79 %)
Significant
improvements mood
and functioning and
seizure frequency both
groups, significantly
more with CBT time
point
(continued)