Cognitive-behavioral treatment of depressed affect among epileptics: Preliminary findings

Armstrong, Hubert E.; Donovan, Dennis M.; Temkin, Nancy

doi:10.1002/1097-4679(198407)40:4<930::aid-jclp2270400410>3.0.co;2-q

Cited by 45 publications

(36 citation statements)

References 2 publications

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“…This analysis found that the four interventions aimed at depression [55,56,68,69] had a moderate effect on reducing depression (SMD = − 0.61; 95% CI − 0.92 to − 0.29); there was only a small, non significant effect on depression for those interventions aimed at psychosocial stressors (SMD = − 0.10; 95% CI − 0.58 to 0.10). [41,67].…”

Section: Group Based Cognitive and Behavioral Interventionsmentioning

confidence: 99%

“…In 8 trials [41,42,55,56,[67][68][69][70] (580 participants) comparing group-based cognitive and behavioral interventions with standard care the intervention had a medium effect on reducing depression at the end of treatment (SMD = − 0.58; 95% CI − 0.99 to − 0.17) and was of moderate quality [41,42,55,56,[67][68][69]. Similar results were found for one study [70] that measured non-remission (RR = 0.41; 95% CI 0.22 to 0.75) and non-response (RR = 0.51; 95% CI 0.29 to 0.91).…”

Section: Group Based Cognitive and Behavioral Interventionsmentioning

confidence: 99%

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A systematic review of non-pharmacological treatments for depression in people with chronic physical health problems

Rizzo

Creed

Goldberg

et al. 2011

Journal of Psychosomatic Research

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Section: Group Based Cognitive and Behavioral Interventionsmentioning

confidence: 99%

Section: Group Based Cognitive and Behavioral Interventionsmentioning

confidence: 99%

A systematic review of non-pharmacological treatments for depression in people with chronic physical health problems

Rizzo

Creed

Goldberg

et al. 2011

Journal of Psychosomatic Research

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“…There is an unfortunate paucity of information on the utility of psychotherapy for depression in patients with epilepsy. However, cognitive behavioral therapy may be useful for depression and social phobia [47,Class II,48,Class IIIb].…”

Section: Nonpharmacologic Approachesmentioning

confidence: 99%

Depression in individuals with epilepsy

Barry

Huynh

Lembke

2000

Curr Treat Options Neurol

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Depression in epilepsy patients is not only extremely common, but is often poorly recognized and inadequately treated. Depression can have significant consequences including increased medical utilization, poor quality of life, social disability, and mortality. Etiology of depression is multifaceted with prominent psychosocial determinants. Salient medical issues include iatrogenic causes, especially side effects of antiepileptic drugs (AEDs). In addition, seizures with increased frequency and with "forced normalization" can be associated with mood disturbance. After a thorough search for correctable causes, treatment should not be delayed, and should include both psychotherapy and pharmacologic therapies. Antidepressants remain the mainstay of pharmacologic intervention with the selective serotonin reuptake inhibitors (SSRIs) considered first-line treatment. Venlafaxine, nefazadone, and tricyclic antidepressants (TCAs) can also be used, but with some important caveats. Decreasing the seizure threshold is a common side effect of all antidepressants, but the risk can be minimized and should not prevent vigorous treatment of the depressive state. Other side effects present with varying frequency from the common (eg, sexual dysfunction as seen with SSRIs) to uncommon withdrawal reactions and rare complications of serotonin syndrome. Depression must also be considered a recurring disease, and when a successful regimen is ascertained, adequate continuation of treatment is a necessity. Care must be taken to treat the patient until complete resolution is achieved. Many patients with a major depressive disorder (MDD) will improve with inadequate treatment, but remain encumbered by a smoldering, low-level dysthymia that, in itself, can severely restrict the patient's quality of life.

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“…CBT was shown to have significant positive effects on mood. [41][42][43] Antidepressants should be considered if there is no improvement after taking the measures discussed above. SSRIs are considered to have the least proconvulsive effect.…”

Section: Management Of Depression In Epilepsymentioning

confidence: 99%

What do we know about depression in people with epilepsy?

Muzerengi¹,

Moor²

2013

Prog Neurol Psychiatry

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Depression is the commonest comorbid psychiatric condition in epilepsy. 1 The relationship between epilepsy and depression was described as far back as 400 BC by Hippocrates. 2 Studies have consistently shown a higher prevalence rate of depression in patients with epilepsy compared with the general population. 3 In a Canadian population-based study, authors reported an estimated lifetime prevalence of mood disorders of 24.4 per cent in individuals with epilepsy, compared to 13.2 per cent in those without. The lifetime prevalence of major depression was 17.4 per cent in those with epilepsy compared to 10.7 per cent in people without epilepsy. 3 Other psychiatric disorders including anxiety, bipolar disorder and suicidal ideation were also more common in the epilepsy group. Higher prevalence rates of up to 48 per cent have been reported in tertiary centre-based studies. 3 These patients were more likely to have refractory epilepsy and temporal lobe epilepsy and hence have an increased risk of comorbid psychiatric disorders. 3,4 Despite its high prevalence in epilepsy, depression remains poorly recognised and undertreated by health professionals. 5 In a study to assess the effect of sertraline on seizure frequency in 100 patients with epilepsy and depression, 60 per cent had a one-year history of psychiatric symptoms, but only 35 per cent of these had been offered or requested treatment within six months of symptom onset. 5 Gilliam et al. found that in the majority of patients, depression is missed because clinicians do not enquire about depressive symptoms. 6 The impact of depression needs to be highlighted. Depression and low mood have been shown to be a strong predictor of health-related quality of life. [6][7][8] Even in people with well controlled seizures, depression remains the main determinant of quality of life. 9 A higher suicide rate has also been reported in people with epilepsy compared with their healthy counterparts. Lifetime prevalence of suicidal ideation in individuals with epilepsy was 25 per cent and 13.3 per cent in healthy controls. 3 Furthermore, the presence of psychiatric illness, and more so depression, has been shown to be associated with poor response to antiepileptic treatment. 10 Hitiris et al. followed up 780 patients with new-onset epilepsy over a median period of 79 months. Patients with epilepsy and psychiatric illnesses were less likely to be seizure free than those with epilepsy without depression. 10 Similar results were found in individuals undergoing epilepsy surgery for temporal lobe epilepsy. Those who had a history of depression were less likely to be seizure or aura free compared with those with epilepsy and no psychiatric history. 11,12 These findings highlight the need for increased awareness of this common psychiatric symptom among clinicians .In this article, we discuss the risk factors, pathophysiology and treatment strategies for depression in epilepsy. What are the risk factors for depression in epilepsy?Several factors including gender, genetics, seizure type, ep...

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Cognitive-behavioral treatment of depressed affect among epileptics: Preliminary findings

Cited by 45 publications

References 2 publications

A systematic review of non-pharmacological treatments for depression in people with chronic physical health problems

A systematic review of non-pharmacological treatments for depression in people with chronic physical health problems

Depression in individuals with epilepsy

What do we know about depression in people with epilepsy?

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