Prevention Of Epilepsy-Related Depression
Depression is one of the most common psychiatric disorders in people with epilepsy. It affects between 32 and 48 percent of people with the disease. Depression is known to have more of an impact on quality of life than frequent seizures.
A team of researchers at the Rollins School of Public Health at Emory University led a study that applied a revised version of a web- and phone-based method focused on preventing, rather than treating depression.
Led by Nancy Thompson, PhD, MPH, associate professor of behavioral sciences and health education, the study, called Project UPLIFT (Using Practice and Learning to Increase Favorable Thoughts), provides an opportunity for patients to learn depression prevention and stress management skills while incorporating techniques to identify and replace negative thoughts and feelings.
"UPLIFT is based on mindfulness and cognitive therapy. Our findings show that by using this revised version of UPLIFT, we are able to prevent depression, reduce seizures and improve quality of life, all at a relatively low cost," says Thompson. "A further benefit is that the materials are delivered to individuals by telephone or Web, which reduces the health disparities for those with limited mobility or those living in rural areas."
UPLIFT works primarily as a "house call" intervention for patients. People dealing with epilepsy often experience barriers such as transportation, frequent seizures and feelings of isolation. UPLIFT targets these barriers by providing home-based prevention tools. Patients can complete on-line modules that raise awareness of the triggers for depression. They can also phone-in to group sessions led by trained facilitators with epilepsy and managed by certified clinicians.
"When a group is moderated by someone with first hand experience, the discussion becomes much more effective, yielding greater results," says Thompson.
The results have proven to be greater indeed. Among those recruited to participate, the incidence of major depression and depressive symptoms were significantly reduced. Participants increased their knowledge and skills for preventing depression, allowing them to incorporate positive techniques to replace negative feelings. They were ultimately able to make clearer decisions about epilepsy treatment and other aspects of life.
Interventions from this study could be easily adapted to other disparity populations who suffer from elevated rates of depression.