Psychological treatments for people with epilepsy

Background Given the significant impact epilepsy can have on the health‐related quality of life (HRQoL) of individuals with epilepsy and their families, there is great clinical interest in evidence‐based psychological treatments, aimed at enhancing psychological well‐being in people with epilepsy. A review of the current evidence was needed to assess the effects of psychological treatments for people with epilepsy on HRQoL outcomes, in order to inform future therapeutic recommendations and research designs. Objectives To assess the effects of psychological treatments for people with epilepsy on HRQoL outcomes. Search methods We searched the following databases on 20 September 2016, without language restrictions: Cochrane Epilepsy Group Specialized Register, CENTRAL, MEDLINE PsycINFO, ClinicalTrials.gov, WHO International Clinical Trials Registry Platform (ICTRP). We screened the references from included studies and relevant reviews, and contacted researchers in the field for unpublished studies. Selection criteria We considered randomized controlled trials (RCTs) and quasi‐RCTs for this review. HRQoL was the main outcome measure. For the operational definition of 'psychological treatments', we included a broad range of treatments that used psychological or behavioral techniques designed to improve HRQoL, seizure frequency and severity, and psychiatric comorbidities for adults and children with epilepsy, compared to treatment as usual (TAU) or an active control group. Data collection and analysis We used standard methodological procedures expected by the Cochrane Collaboration. Main results We included 24 completed RCTs, with a total of 2439 participants. Eleven studies investigated psychological interventions, such as cognitive, behavioral, and mindfulness‐based interventions. The remaining studies were classified as educational interventions (N = 7), self‐management interventions (N = 3), adherence interventions (N = 1), and mixed interventions (N = 2). Two studies investigated interventions for children and adolescents, and five studies investigated interventions for adolescents and adults. Based on satisfactory clinical and methodological homogeneity, we pooled data from six adult studies, two studies on adolescents and adults, and one on adolescents and young adults (468 participants) for HRQoL, measured with the Quality of Life in Epilepsy‐31 (QOLIE‐31). We found significant mean changes for the QOLIE‐31 total score and six subscales (emotional well‐b