Meta-Analysis of Effectiveness of Psychosocial Treatment Programs in Epilepsy

Abstract

Epilepsy is a chronic condition with numerous social and psychological consequences. There are numerous psychological and social factors associated with epilepsy, such as anxiety, depression, and stigma. These factors are prone to have poorer self-esteem, leading to lower quality of life (QOL). The purpose of the current review was to identify the evidence on the effectiveness of psychosocial treatment programs in epilepsy aimed at enhancing the overall QOL in people with epilepsy. Various online databases such as Medline, PubMed, Science Direct, Wiley online library, and Google Scholar were searched to obtain the literature using appropriate search terms/keywords. A total of 68 articles with full texts were reviewed, of which 12 articles (11 randomized studies and 1 nonrandomized study) met the criteria and were included in the meta-analysis with a total sample size of 1712 participants. The methodological quality of the randomized studies was assessed by using the Cochrane Risk of Bias Tool. Various psychosocial treatment programs significantly improved the QOL, self-management, and drug adherence and reduced stigma among persons with epilepsy. However, there was no evidence for effects on epilepsy self-efficacy, depression, anxiety, knowledge, and seizure frequency among persons with epilepsy. Planned psychosocial treatment programs showed significantly important benefit on a number of outcomes but found limited evidence in reducing anxiety, depression, seizure frequency, and improving knowledge among persons with epilepsy. Thus further research is needed to target those specific outcomes. Psychosocial treatment programs must be incorporated by all health-care personnel as an integral part of epilepsy care to promote patients’ optimum well-being.