Authors :
Presenting Author: Ruta Mameniskiene, MD, PhD – Vilnius University
Kristijonas Puteikis, MD – Vilnius University
Arminas Jasionis, MD, PhD – Vilnius University
Asta Jakoniene, MD – Vilnius University
Gintare Auksele, MD – Vilnius University
Peter Wolf, MD, PhD – Vilnius University
Rationale:
Cognitive and psychosocial rehabilitation programs for people with epilepsy (PWE) are known to have insufficient availability worldwide, partly because of limited evidence supporting their effectiveness. We aimed to assess the effects of a newly designed cognitive and psychological consulting intervention on quality of life (QoL) and psychological symptomatology in a mixed sample of adult PWE.
Methods:
Seventy outpatient PWE at Vilnius University Hospital Santaros Klinikos were allocated to either intervention or waitlist by minimization based on age, sex, epilepsy type, and seizure frequency. The intervention consisted of six individual and two group sessions based on psychoeducation, cognitive training, coping strategies, and mindfulness. Follow-ups of 4- and 16-weeks post-intervention included assessment of QoL (QOLIE-31 questionnaire) as primary outcome and symptoms of anxiety (General Anxiety Disorder scale-7, GAD-7), depression (Neurological Disorders Depression Inventory in Epilepsy), and stigma (Jacoby’s 3-item Stigma Scale) as secondary outcomes. Linear mixed models (LMM) with maximum likelihood estimation were used for repeated measures analysis. The study was approved by the Vilnius Regional Bioethics Committee (2023/10-1544-1001).Results:
Of the 70 participants (20 (57.1%) female and 20 (57.1%) with focal epilepsy, in both groups, mean age 35.9 ±11.7, mean epilepsy duration 18.6 ±11.4 years), 61 (87.1%) were followed up at 4 weeks and 55 (78.6%) at 16 weeks. In LMM analysis, a significant group-by-time interaction (F(2, 58.8)=5.751, p=0.005) was observed for QOLIE-31 scores as they increased from 62.6 ±14.5 at baseline to 72.1 ±17.3 at 4-week and 74.7 ±14.1 at 16-week follow-ups post-intervention (p< 0.001). Across QOLIE-31 subscales, a significant group-by-time interaction was present for the Emotional Well-Being score (F(2, 59.9)=6.432, p=0.003) with respective improvements in the intervention group (61.9 ±20.1 to 74.0 ±18.3 to 77.7 ±15.4 points, p< 0.001), but not the waitlist group. A reduction in scores of anxiety (GAD-7) was noted as well (7.2 ±4.3 to 4.6 ±3.8 to 4.3 ±3.5 points, p< 0.001), alongside a group-by-time interaction (F(2, 53.9)=5.685, p=0.006). Significant group-by-time interactions for QOLIE-31 and GAD-7 persisted in the sub-analysis of focal and generalized epilepsy groups. We detected no statistically significant difference in score evolution for symptoms of depression and perceived stigma.