Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Republic of Korea; National Epilepsy Care Center, Seoul, Republic of Korea.
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Republic of Korea.
Epilepsy Behav. 2023 Nov;148:109410. doi: 10.1016/j.yebeh.2023.109410. Epub 2023 Oct 11.
Depression, a common mental problem frequently detected in people with epilepsy (PWE), is a major factor that decreases the quality of life of PWE. The cognitive behavioral therapy (CBT) is the most commonly used non-pharmacological treatment for depressive disorders. The CBT for PWE with depression has not yet been studied in Korea. This study aimed to evaluate the effects of the CBT on depression in PWE in Korea.
This study included 16 PWE with depression who received CBT and 30 control PWE with depression who did not receive CBT. The mean number of CBT sessions per patient was 7.2 in the CBT group. The Beck Depression Inventory-II (BDI-II) and Patient Health Questionnaire-9 (PHQ-9) were administered before and after CBT sessions in the CBT group, whereas PHQ-9 was performed at baseline and follow-up in the control group. The difference in PHQ-9 and BDI-II scores were analyzed between the pre- and post-CBT periods in the CBT group. The difference between baseline and follow-up PHQ-9 scores was compared in the control group.
There was no significant difference in baseline variables between the CBT and control groups. The PHQ-9 score significantly decreased after the CBT sessions in the CBT group (pre-CBT PHQ-9 = 13.56 vs. post-CBT PHQ-9 = 8.56) but it did not change in the control group (Baseline PHQ-9 = 13.83 vs. follow-up PHQ-9 = 14.67). Twelve PWE had undergone four or more CBT sessions with pre-CBT and post-CBT BDI-II. The BDI-II score significantly decreased after CBT sessions (pre-CBT BDI-II = 30.75 vs. post-CBT BDI-II = 21.5). The CBT decreased the sub-field scores of cognitive and physical-emotional factors as well as suicidal ideation, but the score of sleep problems did not significantly improve. The CBT did not significantly change the seizure frequency.
The CBT significantly improved depression in Korean PWE. Therefore, it can be considered a treatment tool for depression in PWE. However, a study with more patients and a fixed number of CBT sessions is recommended to generalize this effect.
抑郁症是一种常见的精神问题，常发生在癫痫患者（PWE）中，是降低 PWE 生活质量的主要因素。认知行为疗法（CBT）是治疗抑郁症最常用的非药物治疗方法。在韩国，尚未研究针对 PWE 抑郁的 CBT。本研究旨在评估 CBT 对韩国 PWE 抑郁的影响。
本研究纳入了 16 名接受 CBT 的抑郁 PWE 和 30 名未接受 CBT 的抑郁对照 PWE。CBT 组每位患者的 CBT 治疗次数平均为 7.2 次。在 CBT 组中，在 CBT 治疗前后进行贝克抑郁自评量表-II（BDI-II）和患者健康问卷-9（PHQ-9）评估，而在对照组中，仅在基线和随访时进行 PHQ-9 评估。分析 CBT 组 CBT 前后 PHQ-9 和 BDI-II 评分的差异。比较对照组基线和随访时 PHQ-9 评分的差异。
CBT 组和对照组的基线变量无显著差异。CBT 组 PHQ-9 评分在 CBT 治疗后显著下降（CBT 前 PHQ-9=13.56，CBT 后 PHQ-9=8.56），而对照组 PHQ-9 评分无变化（基线 PHQ-9=13.83，随访 PHQ-9=14.67）。12 名患者接受了 4 次或更多次 CBT 治疗，并进行了 CBT 前和 CBT 后 BDI-II 评估。CBT 后 BDI-II 评分显著下降（CBT 前 BDI-II=30.75，CBT 后 BDI-II=21.5）。CBT 降低了认知和躯体-情绪因素以及自杀意念的亚领域评分，但睡眠问题的评分无显著改善。CBT 并未显著改变癫痫发作频率。
CBT 可显著改善韩国 PWE 的抑郁症状。因此，它可以被视为治疗 PWE 抑郁的一种手段。然而，建议进行更多患者和固定 CBT 治疗次数的研究，以推广这种效果。
