Universidade Federal de Sao Paulo (UNIFESP), Department of Psychiatry, Brazil.
Universidade Federal de Sao Paulo (UNIFESP), Department of Psychiatry, Brazil; Faculdade de Medicina de Sao Jose do Rio Preto (FAMERP), Department of Psychiatry and Medical Psychology, Brazil.
Epilepsy Behav. 2019 Nov;100(Pt A):106512. doi: 10.1016/j.yebeh.2019.106512. Epub 2019 Sep 28.
Seizure recurrence (SR) after epilepsy surgery in patients with medically resistant temporal lobe epilepsy and mesial temporal sclerosis (TLE-MTS) can compromise medical treatment and quality of life (QOL). However, there is a scarcity of interventions specifically addressing this issue in the literature. We aimed to evaluate the impact of a four-week psychotherapeutic intervention on the levels of resilience, behavioral symptoms, and QOL of patients with drug-resistant TLE-MTS who underwent corticoamygdalohippocampectomy (CAH) and who presented with late SR. Fifty patients who had been diagnosed with TLE-TMS, undergone CAH, and presented with late SR were included. The study instruments included a clinical and sociodemographic questionnaire and the Brazilian versions of the Connor-Davidson Resilience Scale (CD-RISC-10), the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), the Interictal Dysphoric Disorder Inventory (IDDI), and the Quality of Life in Epilepsy Inventory (QOLIE-31). Significant reductions in the IDDI (p < 0.001) and NDDI-E (p < 0.001) scores, improvements in the CD-RISC-10 (p < 0.001) and QOLIE-31 (p < 0.001) scores, and positive correlations between resilience levels and QOL (p < 0.01), as well as a negative correlation between depressive symptoms and resilience (p < 0.01) and QOL (p < 0.01), were observed after the psychotherapeutic intervention. Improvements in the resilience levels and QOL, with concomitant reductions in depressive symptoms, were observed in patients with TLE-MTS and late SR after a brief psychotherapeutic intervention. Since there is a lack of studies that measured the impact of interventions in this patient subpopulation, these results may support the development of treatment strategies for this specific group.
癫痫手术后耐药颞叶癫痫伴内侧颞叶硬化(TLE-MTS)患者的癫痫发作复发(SR)可影响药物治疗效果和生活质量(QOL)。然而,文献中针对这一问题的干预措施相对较少。我们旨在评估为期四周的心理治疗干预对行皮质杏仁核海马切除术(CAH)后出现晚期 SR 的耐药 TLE-MTS 患者的韧性水平、行为症状和 QOL 的影响。共纳入 50 例 TLE-MTS 患者,这些患者均接受过 CAH 治疗且存在晚期 SR。研究工具包括临床和社会人口学问卷以及巴西版 Connor-Davidson 韧性量表(CD-RISC-10)、癫痫神经精神障碍抑郁量表(NDDI-E)、癫痫间期抑郁障碍量表(IDDI)和癫痫生活质量量表(QOLIE-31)。IDDI(p<0.001)和 NDDI-E(p<0.001)评分显著降低,CD-RISC-10(p<0.001)和 QOLIE-31(p<0.001)评分提高,韧性水平与 QOL 呈正相关(p<0.01),抑郁症状与韧性(p<0.01)和 QOL(p<0.01)呈负相关。心理治疗干预后,TLE-MTS 和晚期 SR 患者的韧性水平和 QOL 提高,抑郁症状减少。由于缺乏针对该患者亚群的干预措施影响的研究,这些结果可能为这一特定群体的治疗策略提供支持。