Treatment of depression in patients with temporal lobe epilepsy: A pilot study of cognitive behavioral therapy vs. selective serotonin reuptake inhibitors
Abstract
There is a high prevalence of depression in patients with epilepsy, which negatively impacts their quality of life (QOL) and seizure control. Currently, the first-line of treatment for depression in patients with epilepsy is based on selective serotonin reuptake inhibitors (SSRIs). The main objective of this pilot study was to compare cognitive behavioral therapy (CBT) versus SSRIs for the treatment of major depressive disorder (MDD) in patients with temporal lobe epilepsy (TLE). Seven patients who received group CBT were compared with eight patients treated with SSRIs. All were diagnosed with MDD and TLE. Patients were assessed at baseline before treatment and at six and 12weeks during treatment with the Quality of Life in Epilepsy Scale of 31 items (QOLIE 31), the Beck Depression Inventory (BDI), and the Hospital Anxiety and Depression Scale (HADS). Seizure records were also taken on a monthly basis. After 12weeks of treatment, both groups showed improved QOL and reduced severity of depression symptoms. There were no statistically significant group differences in the final scores for the BDI (p=0.40) and QOLIE 31 (p=0.72), although the effect size on QOL was higher for the group receiving CBT. In conclusion, the present study suggests that both CBT and SSRIs may improve MDD and QOL in patients with TLE. We found no significant outcome differences between both treatment modalities. These findings support further study using a double-blind controlled design to demonstrate the efficacy of CBT and SSRIs in the treatment of MDD and QOL in patients with TLE.
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Severity of depressive symptoms was used as an inclusion criterion in 5 studies (21%).
“Severity of depressive symptoms was used as an inclusion criterion in 5 studies (21%; see Table 1). 26,27,29 -32”
From Cochrane systematic review and meta-analysis of the impact of psychological treatments for people with epilepsy on health-related quality of life (2018) · cites this paper as [30]
One study was rated with very serious ROB because the allocation depended on the participants' feasibility to attend the meetings.
“One study 30 was rated with very serious ROB because the allocation depended on the participants ' ' feasibility to attend the meetings. '”
From Cochrane systematic review and meta-analysis of the impact of psychological treatments for people with epilepsy on health-related quality of life (2018) · cites this paper as [30]
Of the 24 studies, 11 examined group therapy (46%).
“Of the 24 studies, 11 examined group therapy (46%), 20,29,30,33,37,38,40 -42,46,47”
From Cochrane systematic review and meta-analysis of the impact of psychological treatments for people with epilepsy on health-related quality of life (2018) · cites this paper as [30]
QOLIE-31/31-P/-89 was used in 17 studies (71%), of which 12 (70%) were considered for meta-analyses due to satisfactory methodological homogeneity.
“It was used in 17 studies (71%), of which 12 (70%) were considered for meta-analyses due to satisfactory methodological homogeneity. 26,27,29,30,33,36,37,41,46,47,49,50”
From Cochrane systematic review and meta-analysis of the impact of psychological treatments for people with epilepsy on health-related quality of life (2018) · cites this paper as [30]
The meta-analysis comprised data from 9 studies (37%) with a total of 468 participants.
“Consequently, the meta-analysis comprised data from 9 studies (37%) 26 -30,33,36,46,49,50 with a total of 468 participants (see studies highlighted in gray in Table 1).”
From Cochrane systematic review and meta-analysis of the impact of psychological treatments for people with epilepsy on health-related quality of life (2018) · cites this paper as [30]
The most commonly used scale for depressive symptoms was the Beck Depression Inventory/Beck Depression Inventory-II, which was used in 5 studies (45%).
“The most commonly used scale was the Beck Depression Inventory/Beck Depression Inventory-II, which was used in 5 studies (45%). 29 -32,36”
From Cochrane systematic review and meta-analysis of the impact of psychological treatments for people with epilepsy on health-related quality of life (2018) · cites this paper as [30]
Four of the 11 studies (36%) reported nonsignificant results for depressive symptoms.
“Four of the 11 studies (36%) reported nonsignificant results 24,30,43,50 ; Caller et al. 50 and Orjuela-Rojas et al. 30 used > 1 outcome measure (Table 4A).”
From Cochrane systematic review and meta-analysis of the impact of psychological treatments for people with epilepsy on health-related quality of life (2018) · cites this paper as [30]
Caller et al. and Orjuela-Rojas et al. used >1 outcome measure.
“Caller et al. 50 and Orjuela-Rojas et al. 30 used > 1 outcome measure (Table 4A).”
From Cochrane systematic review and meta-analysis of the impact of psychological treatments for people with epilepsy on health-related quality of life (2018) · cites this paper as [30]
A total of 5 studies (21%) included anxiety level as an outcome measure, and all of them reported no significant baseline difference between the treatment and control groups.
“A total of 5 studies (21%) included anxiety level as an outcome measure 28,30,36,43,46 ; all of them reported no significant baseline difference between the treatment and control groups.”
From Cochrane systematic review and meta-analysis of the impact of psychological treatments for people with epilepsy on health-related quality of life (2018) · cites this paper as [30]
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Spurgeon, E., Ivaniuk, A., Sodani, S., Butler, E., Martinez, D., Schleicher, M. C., Taylor, S. C., Saper, R. B., Najm, I., & Lal, D. (2026) · Epilepsia · doi:10.1002/epi.70316
- Authors
- Orjuela-Rojas, J. M., Martínez-Juárez, I. E., Ruiz-Chow, A., & Crail-Melendez, D.
- Affiliations
- Instituto Nacional de Neurología y Neurocirugía (MX)
- Venue
- Epilepsy & Behavior
- Publisher
- Elsevier BV
- Published
- 2015-10
- Volume
- 51
- Pages
- 176-181
- ISSN
- 1525-5050 (ISSN-L)
- OpenAlex
- W1921727148
- Cited by
- 37
- References
- 42
- Citations by year
- 2026: 1 · 2025: 2 · 2023: 3 · 2022: 3 · 2021: 6 · 2020: 4 · 2019: 5 · 2018: 7 · 2017: 4 · 2016: 1 · 2014: 1
- FWCI
- 3.24
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Epilepsy & Behavior (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Department of Neuropsychiatry
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Epilepsy research and treatment
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- depression, temporal lobe epilepsy, cognitive behavioral therapy, selective serotonin reuptake inhibitors, major depressive disorder, quality of life, seizure control, psychotherapy versus pharmacotherapy
- MeSH terms
- Adult, Depression, Double-Blind Method, Epilepsy, Temporal Lobe, Female, Humans, Male, Middle Aged, Pilot Projects, Psychiatric Status Rating Scales, Quality of Life, Cognitive Behavioral Therapy, Treatment Outcome, Selective Serotonin Reuptake Inhibitors
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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