The effectiveness of psychological interventions for patients with relatively well-controlled epilepsy

Previous reviews about psychological interventions focused on refractory epilepsy patients and were inconclusive; this review investigates what the contribution of the psychologist can be for the large group of patients with relatively well-controlled epilepsy. This review was restricted to the literature reporting on adult patients with relatively well-controlled epilepsy. A literature search on the effect of psychological interventions was conducted using Medline and PsychInfo, including those studies published through March 2002. Applying strict inclusion criteria, a total of seven studies were identified. Four studies incorporated a waiting-list control group. Of these, one study addressing cognitive rehabilitation reported positive results on psychological outcome and one intervention based on comprehensive care led to seizure reduction, whereas all other studies were plagued too much by methodological inadequacies to allow firm conclusions to be drawn. Recommendations for future intervention studies, such as standardized interventions, controlling for positive attention, outcome measures without overlap with the intervention, and a follow-up measurement, are given. It is concluded that a concerted effort to assemble larger patient groups in randomized-controlled studies is a prerequisite to acquiring well-founded knowledge about psychological interventions in patients with relatively well-controlled epilepsy.