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短程心理治疗干预对耐药性内侧颞叶癫痫患者的韧性和行为以及术后晚期复发的影响。

Effects of a brief psychotherapeutic intervention on resilience and behavior in patients with drug-resistant mesial temporal lobe epilepsy and late seizure recurrence after surgery.

机构信息

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.

出版信息

Epilepsy Behav. 2019 Nov;100(Pt A):106512. doi: 10.1016/j.yebeh.2019.106512. Epub 2019 Sep 28.

Abstract

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.

摘要

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。

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