School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5005, Australia.
School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5005, Australia.
Epilepsy Behav. 2022 Sep;134:108766. doi: 10.1016/j.yebeh.2022.108766. Epub 2022 Jul 27.
PURPOSE/OBJECTIVE: Research on third-wave cognitive behavioral therapies has burgeoned over the last ten years. However, questions remain about the effectiveness of these therapies for people with epilepsy. This article provides an up-to-date review of the current evidence-base.
Following protocol registration (PROSPERO CRD42021269882), two reviewers searched six databases (from inception until 1 March 2022) for mindfulness and acceptance interventions targeted at mental health in adults with epilepsy. The reporting quality of included studies was rated (QualSyst tool) and standardized mean group differences (Hedges' g) with 95% confidence intervals and p values calculated. Results were narratively synthesized based on therapy characteristics and mental health outcome.
Eleven randomized controlled trials, involving 941 adults with chronic epilepsy, were included. All studies were of sound methodological quality. Third-wave therapies were typically delivered in a group format although varied in their face-to-face, telephone, and online learning options. Programs evaluating Acceptance and Commitment Therapy, Mindfulness-Based Cognitive Therapy, or elements of both, outperformed wait-listed controls or usual care, although individual variability in treatment response was evident (g = -0.11-2.28).
Acceptance techniques and mindfulness practice may bring mental health benefits for some people living with epilepsy, but do not have consistent results for everyone. Patient diversity and preferences need to be factored into effective third-wave approaches for this cohort.
目的/目标：过去十年，第三波认知行为疗法的研究蓬勃发展。然而，这些疗法对癫痫患者的有效性仍存在疑问。本文提供了对当前证据基础的最新综述。
在方案注册（PROSPERO CRD42021269882）后，两名审查员从六个数据库（从成立到 2022 年 3 月 1 日）中搜索了针对癫痫成人心理健康的正念和接纳干预措施的研究。使用 QualSyst 工具对纳入研究的报告质量进行了评估，并计算了标准化组间差异（Hedges'g）及其 95%置信区间和 p 值。结果根据治疗特点和心理健康结果进行了叙述性综合。
纳入了 11 项随机对照试验，涉及 941 名慢性癫痫成人。所有研究的方法学质量都很好。第三波疗法通常以小组形式进行，但面对面、电话和在线学习方式各不相同。评估接纳与承诺疗法、正念认知疗法或两者结合的方案，优于候补对照组或常规护理，但治疗反应的个体差异明显（g= -0.11 至 2.28）。
接纳技术和正念练习可能会给一些癫痫患者带来心理健康益处，但并非对所有人都有效。患者的多样性和偏好需要纳入针对这一人群的有效第三波方法。
