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Psychological treatments for epilepsy.
S Ramaratnam1, G A Baker, L Goldstein
1Department of Neurology, Apollo Hospitals, 21 Greams Lane, Off Greams Road, Madras, Tamil Nadu, India, 60006.
The Cochrane Database of Systematic Reviews
|October 30, 2003
Summary
Psychological interventions for epilepsy show limited reliable evidence for reducing seizure frequency. While some methods improved mood and coping, further high-quality trials are needed to confirm benefits.
Area of Science:
- Neurology
- Psychology
- Evidence-Based Medicine
Background:
- Psychological interventions, including relaxation therapy, cognitive behavioral therapy (CBT), electroencephalogram (EEG) bio-feedback, and educational interventions, are explored for epilepsy management.
- These methods are utilized individually or in combination to potentially decrease seizure frequency and enhance the quality of life for individuals with epilepsy.
Purpose of the Study:
- To evaluate the efficacy of psychological interventions in reducing seizure frequency in epilepsy patients.
- To determine if psychological treatments improve the quality of life for individuals diagnosed with epilepsy.
Main Methods:
- A systematic search of major databases including Cochrane Epilepsy Group, Cochrane Central Register of Controlled Trials, and MEDLINE was conducted.
- Included studies were randomized or quasi-randomized trials assessing psychological or behavior modification techniques in people with epilepsy.
- Data extraction and assessment were performed independently by two reviewers, with primary analyses based on intention-to-treat, focusing on seizure frequency and quality of life outcomes.
Main Results:
- Three small, low-quality trials on relaxation therapy (50 participants) showed no significant effect on seizure frequency.
- Cognitive behavioral therapy demonstrated effectiveness in reducing depression in some individuals but not seizure frequency in others.
- Combined relaxation and behavior therapy showed benefits for anxiety and adjustment, while EEG bio-feedback and educational interventions indicated potential improvements in cognitive function, knowledge, and coping strategies.
Conclusions:
- Current evidence from limited, methodologically deficient studies does not reliably support the use of psychological interventions for reducing seizure frequency in epilepsy.
- Further rigorous, large-scale randomized controlled trials are necessary to establish the effectiveness of these psychological approaches in epilepsy management.