Cognitive behaviour therapy with adults' with intractable epilepsy and psychiatric co-morbidity: preliminary observations on changes in psychological state and seizure frequency
Abstract
Cognitive behaviour therapy (CBT) was undertaken with six adults with chronic, poorly controlled seizures and co-existing psychiatric and/or psychosocial difficulties. During 12 sessions of CBT from an experienced CBT Nurse Specialist, treatment focused concurrently on epilepsy-related problems, associated psychopathology and on the development of psychological strategies to reduce seizure occurrence. At the end of treatment participants rated their initial epilepsy-related problem as having less impact on their daily lives and at one-month follow-up reported less deleterious impact on everyday life in terms of their psychological difficulties. In addition participants demonstrated significant improvements in terms of their self-rated work and social adjustment, and in their decreased use of escape-avoidance coping strategies. These positive findings occurred despite the absence of a significant decrease in seizure frequency. Issues raised by the complexity and severity, both of these patients' psychological/psychosocial difficulties and their epilepsy, are discussed in relation to the optimal length of treatment that may be required when adopting a CBT model in this patient group.
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The WSAS is a valid, reliable and sensitive measure in a number of different disorders, including depression, anxiety, OCD, phobic disorders, or insomnia, and in patients with psychogenic non-epileptic seizures.
“The WSAS has been established as a valid, reliable and sensitive measure in a number of different disorders, including depression, anxiety, OCD, phobic disorders, or insomnia and it has proven a sensitive measure in a number of studies of patients with psychogenic non-epileptic seizures [25-29].”
From A prospective service evaluation of acceptance and commitment therapy for patients with refractory epilepsy (2015) · cites this paper as [26]
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- Authors
- Goldstein, L. H., McAlpine, M., Deale, A., Toone, B. K., & Mellers, J. D. C.
- Affiliations
- King's College London (GB)
- Maudsley Hospital (GB)
- Corresponding author
- Goldstein, L.H
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 2003-04
- Volume
- 41
- Issue
- 4
- Pages
- 447-460
- ISSN
- 0005-7967 (ISSN-L)
- OpenAlex
- W2069306966
- Cited by
- 60
- References
- 36
- Citations by year
- 2026: 2 · 2022: 1 · 2021: 1 · 2020: 1 · 2019: 1 · 2018: 3 · 2017: 5 · 2016: 2 · 2015: 2 · 2014: 6 · 2013: 2 · 2012: 3
- FWCI
- 1.84
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Behaviour Research and Therapy (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Epilepsy research and treatment
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- cognitive behavioral therapy, drug-resistant epilepsy, psychiatric comorbidity, seizure frequency, psychological state, psychosocial problems, escape-avoidance coping, work and social adjustment, treatment duration, specialist nurses
- MeSH terms
- Adaptation, Psychological, Adult, Aged, Mental Disorders, Chronic Disease, Epilepsy, Female, Follow-Up Studies, Humans, Middle Aged, Psychiatric Status Rating Scales, Social Adjustment, Cognitive Behavioral Therapy
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