Cognitive behavior therapy for depression in people with epilepsy: A systematic review
Open accessAbstract
Summary: Cognitive behavioral therapy (CBT) is a recommended treatment for depression in people with epilepsy (PWE); however, a recent C ochrane review found that there was insufficient evidence that any psychological therapy is effective. This conclusion provides little help to clinicians who provide interventions for depressed PWE. The aim of this review was to systematically and qualitatively review the literature on the efficacy of CBT for depression in PWE based on randomized controlled trials (RCT s) and case series. We aim to determine patterns in the literature to inform the type of CBT, if any, that should be offered to PWE who are depressed. Databases MEDLINE,P syc INFO, and the C ochrane EBM Reviews were searched via OVID. Selection criteria included the following: (1) participants with epilepsy; (2) use of CBT; (3) valid depression outcome measure; and (4) published in peer‐reviewed journal in E nglish. Inclusions of studies were assessed by two independent researchers. We identified 14 outcome papers for 13 CBT trials including 6 randomized controlled trials (RCT s) and 7 case series. Positive effects of CBT on depression were reported in three of six RCT s. A review of their content revealed that all effective RCT s specifically tailored CBT to improve depression. Conversely, two of three RCT s that failed to find depression‐related effects focused on improving seizure‐control. This pattern was also observed in the case series. Although limited in number and having methodologic limitations, the treatment studies included in our review suggest that interventions tailored toward improving depression are possibly efficacious, whereas those that focus on improving seizure control do not appear to be. However, this review highlights that there is need for further RCT s in this area in order to confirm the possible efficacy of CBT for depression in PWE.
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Over the past decade, additional trials with substantially improved designs have become available that have been critically appraised in recent reviews, providing growing evidence for positive effects of psychological treatments on wider HRQoL, psychiatric symptoms, psychological functioning, and seizure control in people with epilepsy.
“Over the past decade, additional trials with substantially improved designs have become available that have been critically appraised in a number of recent reviews, 16,18 providing growing evidence for the positive effects of psychological treatments on wider HRQoL, psychiatric symptoms (ie, anxiety, depression), psychological functioning (ie, self-management), and seizure control in PWE.”
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 [18]
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Experimental — accuracy not yet measuredThis review is in keeping with a systematic review of cognitive behavior therapy for depression in PWE that suggested interventions tailored toward improving depression are possibly efficacious.
“this review is in keeping with a systematic review of cognitive behavior therapy for depression in PWE 18 that suggested interventions tailored toward improving depression are possibly efficacious.”
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 [18]
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Leplow, B., & Paetow, K. (2015) · Springer-Lehrbuch · doi:10.1007/978-3-662-48035-9_15
Non-Pharmacologic Management of Epilepsy
Krishnamoorthy, E. S., Shorvon, S. D., & Schachter, S. C. (2017) · Epilepsy · doi:10.1017/9781139547918.033
La depressione nell'epilessia. Cause, diagnosi e trattamento
D’Amico, R. (2018) · PSICOLOGIA DELLA SALUTE · doi:10.3280/pds2018-003002
Constantinou, M. (2020) · Journal of Psychiatry and Psychiatric Disorders · doi:10.26502/jppd.2572-519x0094
Burbridge, J. A., & Leveroni, C. L. (2016) · Springer eBooks · doi:10.1007/978-3-319-29294-6_9
Diagnosis and Treatment of Depression in Patients with Epilepsy
Park, S.-P. (2022) · Epilia Epilepsy and Community · doi:10.35615/epilia.2022.00347
The effect of cognitive behavioral therapy on depression of people with epilepsy
Kim, M., Jung, S., Kim, J. S., & Hong, S. B. (2023) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2023.109410
Psychological Aspects of Epilepsy Surgery
Rosenkoetter, U., Clusmann, H., Ort, J., & Honrath, P. (2026) · Springer eBooks · doi:10.1007/978-3-032-04182-1_52
Sun, Y., Wang, J., Guan, Y., & Wu, Z. (2026) · Frontiers in Medicine · doi:10.3389/fmed.2026.1917962
- Authors
- Gandy, M., Sharpe, L., & Perry, K. N.
- Affiliations
- The University of Sydney (AU)
- Western Sydney University (AU)
- Corresponding author
- Gandy, Milena
- Venue
- Epilepsia
- Publisher
- Wiley
- Published
- 2013-09-03
- Volume
- 54
- Issue
- 10
- Pages
- 1725-1734
- ISSN
- 0013-9580 (ISSN-L)
- 1528-1167
- OpenAlex
- W1975643987
- Cited by
- 65
- References
- 43
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 2 · 2023: 4 · 2022: 5 · 2021: 2 · 2020: 4 · 2019: 8 · 2018: 6 · 2017: 11 · 2016: 7 · 2015: 6 · 2014: 7
- FWCI
- 1.10
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Epilepsia (publishedVersion)
- PubMed (publishedVersion)
- Funders
- James S. McDonnell Foundation
- Epilepsy Society of Australia
- Epilepsy Society
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Health Sciences › Medicine › Psychiatry and Mental health › Epilepsy research and treatment
- Keywords
- cognitive behavioral therapy, depression, epilepsy, treatment efficacy, seizure control
- MeSH terms
- Depression, Epilepsy, Humans, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Treatment Outcome
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