Psychosocial treatment programs in epilepsy: a review.

Psychosocial problems are a major unmet treatment need in epilepsy. The purpose of this review was to describe published psychosocial treatment interventions in the English medical literature. Seventeen outcome studies for 15 treatments were found. Survival past proof of concept was a problem, with only four programs making it into current use. With important exceptions, treatments met with limited success. Several were successful with medical education, improving quality of life, social adjustment, and adjustment to seizures. A psychological intervention for seizure control for patients with refractory epilepsy was outstanding. Research problems included few control groups, a dependence on paper-and-pencil measures, limited variables, and only one study with serum determination for compliance. Low cost-effectiveness was a problem. Only one approach showed economic promise. Low participation by patients was an unexpected barrier. Psychosocial treatments should be targeted for development and needs to be integrated into the treatment flow of specialty clinics.