Psychosomatic Medicine and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany.
Epilepsy Center, Department of Neurosurgery, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany.
Psychopathology. 2023;56(6):417-429. doi: 10.1159/000528924. Epub 2023 Mar 16.
Mental health comorbidities such as depression and anxiety are common in epilepsy, especially among people with pharmacoresistant epilepsy who are candidates for epilepsy surgery. The Psychology Task Force of the International League Against Epilepsy advised that psychological interventions should be integrated into comprehensive epilepsy care.
To better understand the psychological impact of epilepsy and epileptic seizures in epilepsy surgery candidates, we analysed interviews with this subgroup of patients using Karl Jaspers' concept of limit situations, which are characterised by a confrontation with the limits and challenges of life. These are especially chance, randomness, and unpredictability, death and finitude of life, struggle and self-assertion, guilt, failure, and falling short of one's aspirations.
In 43 interviews conducted with 15 people with drug-resistant epilepsy who were candidates for epilepsy surgery, we found that these themes are recurrent and have a large psychosocial impact, which can result in depression and anxiety. For some people, epileptic seizures appear to meet the criteria for traumatic events.
Understanding epilepsy and seizures as existential challenges complements the neurobiological explanations for psychological comorbidities and can help tailor psychological interventions to the specific needs of people with epilepsy, especially those who are candidates for surgical treatment.
精神健康合并症，如抑郁和焦虑，在癫痫中很常见，尤其是在那些药物难治性癫痫患者中，他们是癫痫手术的候选者。国际抗癫痫联盟心理学工作组建议，心理干预应该整合到全面的癫痫护理中。
为了更好地了解癫痫手术候选者的癫痫和癫痫发作的心理影响，我们使用卡尔·雅斯贝尔斯的极限情况概念分析了这一小组患者的访谈，这些情况的特点是与生活的极限和挑战相遇。这些情况特别包括偶然性、随机性和不可预测性、死亡和生命的有限性、挣扎和自我主张、内疚、失败和未能实现自己的愿望。
在对 15 名药物难治性癫痫患者进行的 43 次访谈中，我们发现这些主题是反复出现的，对他们的心理社会产生了重大影响，可能导致抑郁和焦虑。对一些人来说，癫痫发作似乎符合创伤性事件的标准。
将癫痫和癫痫发作理解为存在的挑战，补充了对心理合并症的神经生物学解释，并可以帮助针对癫痫患者的具体需求定制心理干预措施，尤其是那些手术治疗的候选者。
