Efficacy of a psychological online intervention for depression in people with epilepsy: A randomized controlled trial
Open accessAbstract
Summary: Objective: Depression is the most prevalent psychiatric disorder in persons with epilepsy (PWE s). Despite its major impact on quality of life and risk of suicide, most PWE s are not treated for depression. A current challenge in mental health care is how to close this treatment gap and increase access to psychological services. Psychological online interventions (POI s) have shown efficacy in improving depression among individuals without neurologic disorders. This pilot study aimed to assess the feasibility and efficacy of a psychological online intervention for depression (Deprexis) in PWE s who have symptoms of depression. Methods: Participants with self‐reported epilepsy and subjective complaints of depressive symptoms were randomized to an intervention condition (Deprexis) or to a waiting list control (WLC) condition. After 9 weeks, participants were invited to complete an online reassessment. Results: Relative to the waiting list group, program users experienced a significant symptom decline on the Beck Depression Inventory ‐ I (BDI‐I, primary outcome) with a moderate effect size in the complete observations analysis and a small effect size in the intention‐to‐treat analysis. Furthermore, there was a significant improvement with a moderate effect size on the “energy/fatigue” subscale of the Quality of Life In Epilepsy Inventory ‐ 31 (QOLIE‐31). Significance: The results of this trial suggest that POI s may be a feasible and beneficial tool for PWE s who have comorbid depressive symptoms.
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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 [32]
The Inclusion and exclusion criteria section says participants without self-reported depressive symptoms were excluded, so depressive symptoms did affect eligibility. It also says the criteria included subclinical symptoms; it does not describe a required symptom-severity level. This individual trial cannot establish the citing paper’s tally of five studies (21%). (LLM, conf=0.84)
Experimental — accuracy not yet measuredA rating of low ROB was confirmed based on document review of registered protocols provided by the authors for 9 studies (37%).
“A rating of low ROB was confirmed based on document review of registered protocols provided by the authors for 9 studies (37%). 32,36,40,42,44 -46,49,50”
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 [32]
The Acknowledgements identify this trial as registered at ClinicalTrials.gov (NCT01663649), supporting its identification as a registered study. The paper does not report that its authors provided a protocol for document review, that reviewers confirmed a low risk-of-bias rating, or that this was one of nine studies (37%). (LLM, conf=0.78)
Experimental — accuracy not yet measuredIn the QOLIE-31 study Schr € oder 32, the intervention group had a mean postintervention score of 31.72 (SD 13.37) versus control 32.56 (SD 13.37), P=.755.
“Schr € oder 32 | 31.72 | 13.37 | 32.56 | 13.37 | .755”
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 [32]
Table 3 reports a QOLIE-31 overall-quality-of-life comparison with p = 0.755, supporting that part of the citation. But its postintervention values are 8.71 (0.58) for Deprexis and 7.81 (0.50) for the waiting-list control, not the claimed means and SDs; the QOLIE-31 total score has p = 0.667. The indexed copy provides no page number for Table 3. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThere were no personnel involved to be blinded in 2 studies (8%) investigating a Web-based intervention.
“There were no personnel involved to be blinded in 2 studies (8%) investigating a Web-based intervention. 32,45”
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 [32]
Almost half of all study designs included a wait list control (WLC) group (n = 11, 46%).
“Almost half of all study designs included a wait list control (WLC) group (n = 11, 46%). 28,31 -33,37,38,40,42,43,45,46”
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 [32]
Two studies (8%) used an Internet-based delivery method.
“Two studies (8%) used an Internetbased delivery method, 32,45”
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 [32]
The risk of infidelity to the intervention protocol was considered very low when the delivery of the intervention was Internet-based only (n = 2, 8%).
“and very low when the delivery of the intervention was Internet-based only (n = 2, 8%). 32,45”
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 [32]
Seven studies (64%) reported a significant postintervention difference between the intervention and the control groups for depressive symptoms.
“Seven studies (64%) reported a significant postintervention difference between the intervention and the control groups. 26 -29,31,32,36,46”
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 [32]
The remaining 4 studies (50%) did not report a significant difference between postintervention total scores when comparing treatment and control groups.
“The remaining 4 studies (50%) did not report a significant difference between postintervention total scores when comparing treatment and control groups (Table 3A). 25,32,43,44”
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 [32]
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 [32]
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- Authors
- Schröder, J., Brückner, K., Fischer, A., Lindenau, M., Köther, U., Vettorazzi, E., & Moritz, S.
- Affiliations
- University Medical Center Hamburg-Eppendorf (DE)
- Evangelisches Krankenhaus Alsterdorf (DE)
- Corresponding author
- Schröder, Johanna
- Venue
- Epilepsia
- Publisher
- Wiley
- Published
- 2014-11-19
- Volume
- 55
- Issue
- 12
- Pages
- 2069-2076
- ISSN
- 0013-9580 (ISSN-L)
- 1528-1167
- OpenAlex
- W2021491081
- Cited by
- 96
- References
- 30
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 11 · 2023: 11 · 2022: 4 · 2021: 5 · 2020: 11 · 2019: 10 · 2018: 11 · 2017: 12 · 2016: 12 · 2015: 2
- FWCI
- 13.43
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Epilepsia (publishedVersion)
- PubMed (publishedVersion)
- CLOK (University of Central Lancashire) (acceptedVersion)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- depression, epilepsy, Deprexis, depressive symptoms, treatment gap, feasibility, fatigue, quality of life, comorbidities, digital mental health
- MeSH terms
- Adult, Depression, Epilepsy, Female, Humans, Male, Middle Aged, Online Systems, Psychiatric Status Rating Scales, Quality of Life, Surveys and Questionnaires, Psychotherapeutic Processes, Treatment Outcome
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