Psychological treatments for adults and children with epilepsy: Evidence-based recommendations by the ILAE Psychology Task Force

Rosa Michaelis, Venus Tang, Laura Hilary Goldstein, Markus Reuber, W Curt LaFrance Jnr, Tobias Lundgren, Avani C Modi, Janelle Wagner

Research output: Contribution to journalLiterature reviewpeer-review

108 Citations (Scopus)
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Abstract

Given the significant impact that psychosocial factors and epilepsy treatments can have on the health-related quality of life (HRQOL) of individuals with epilepsy and their families, there is great clinical interest in the role of psychological evaluation and treatments to improve HRQOL and comorbidities. Therefore, the ILAE charged the Psychology Task Force with the development of recommendations for clinical care based on evaluation of the evidence from their recent Cochrane review of psychological treatments in individuals with epilepsy. The literature search for a recent Cochrane review of Randomized Controlled Trials (RCTs) investigating psychological treatments for individuals with epilepsy constitutes the key source of evidence for this article. In order to provide practical guidance to service providers, we provide ratings on study research designs based on 1) the American Academy of Neurology’s (AAN) Level of Evidence (LOE) system and 2) the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. This paper is the culmination of an international collaboration process involving pediatric and adult psychologists, neurologists, psychiatrists and neuropsychiatrists. The process and conclusions were reviewed and approved by the ILAE Executive Committee. The strongest evidence for psychological interventions was identified for the most common mental health problems, including depression, neurocognitive disturbances, and medication adherence. Psychological interventions targeting the enhancement of HRQOL and adherence and a decrease in comorbidity symptoms (anxiety, depression) should be incorporated into comprehensive epilepsy care. There is a range of psychological strategies (i.e., CBT and mindfulness-based therapies), which show promise for improving the lives of persons with epilepsy, and clinical recommendations are provided to assist epilepsy health care providers in treating the comorbidities and challenges associated with epilepsy and its treatments.
Original languageEnglish
Pages (from-to)1282-1302
JournalEpilepsia
Volume59
Issue number7
Early online date19 Jun 2018
DOIs
Publication statusPublished - Jul 2018

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