Expanding the efficacy of Project UPLIFT: Distance delivery of mindfulness-based depression prevention to people with epilepsy.

Abstract

Objective Depression affects about 16% of the U.S. population over a lifetime. People with chronic diseases have especially high rates of co-morbid depression; 32% to 48% of people with epilepsy experience depression. This study evaluated the efficacy of a mindfulness-based cognitive therapy (MBCT) intervention for preventing major depressive disorder (MDD) episodes in people with epilepsy. Method Participants (n = 128) were adults from Georgia, Michigan, Texas, and Washington with epilepsy and mild/moderate depressive symptoms. The eight-session, weekly Project UPLIFT intervention, based on MBCT, was group-delivered via Web or telephone. Using a randomized, controlled, cross-over design, participants were assigned to Project UPLIFT or a treatment-as-usual (TAU) waitlist and assessed at baseline, and after intervening in the intervention group (~10 weeks) and in the TAU group (~20 weeks). Assessments included valid self-report measures of depression and MDD, knowledge/skills, and satisfaction with life. Results The incidence of MDD episodes (new or relapse) from baseline to interim assessment was significantly lower in the intervention condition (0.0%) than in TAU (10.7%). Depressive symptoms decreased significantly more in the intervention condition than in TAU; Web- and telephone did not differ. Change in knowledge/skills mediated the effect, which persisted over the 10 weeks of follow-up. Knowledge/skills and life satisfaction increased significantly more in the intervention condition than in TAU. Conclusions Distance delivery of group MBCT can prevent episodes of MDD, reduce symptoms of depression, and increase life satisfaction in people with epilepsy. This intervention is easily modified for persons with other chronic diseases and other disparity populations.

Written Accounts of Living With Epilepsy or Psychogenic Nonepileptic Seizures: A Thematic Comparison

“…For example, cognitive behavioural therapy (Goldstein et al, 2010), mindfulness (Baslet, Dworetzky, Perez, Dworetzky, & Oser, 2015), and acceptance-commitment therapy (Cope, Poole, & Agrawal, 2017). Individuals with epilepsy may also benefit from such treatments to help manage with the sequelae of their condition (Dewhurst, Novakova, & Reuber, 2015;Thompson et al, 2015).…”

Targeted Self-Management of Epilepsy and Mental Illness for individuals with epilepsy and psychiatric comorbidity

“…Thompson and colleagues[15] evaluated UPLIFT (Using Practice and Learning to Increase Favorable Thoughts), a remotely-delivered self-management intervention for people with epilepsy and depression. Using a randomized, controlled crossover design, 128 adults with epilepsy and mild/moderate depressive symptoms were assigned to either UPLIFT or TAU waitlist.…”

Digital Characteristics and Dissemination Indicators to Optimize Delivery of Internet-Supported Mindfulness-Based Interventions for People With a Chronic Condition: Systematic Review (Preprint)

“…This analysis did not include a comparative group, and was therefore excluded from the review. Two other studies met the inclusion criteria, but their interventions combined two delivery modes (web-based and telephone-based), and outcome data were not reported by delivery mode [39,40]. Since effect size, attrition and adherence rates for the web-based group were not available, these latter studies were also excluded.…”