PEARLS depression treatment for individuals with epilepsy: a randomized controlled trial.
OBJECTIVE
Depression is associated with higher rates of suicide and lower levels of functioning and quality of life in individuals with epilepsy. The objective of this randomized controlled trial was to determine the effectiveness of PEARLS, a home-based program for managing depression in adult individuals with epilepsy and clinically significant acute and chronic depression.


METHODS
Delivered by masters-level counselors, PEARLS is a collaborative care intervention consisting of problem solving treatment, behavioral activation, and psychiatric consultation. Patients were randomly assigned to the PEARLS intervention (N = 40) or usual care (N = 40), and assessed at baseline, 6 months, and 12 months.


RESULTS
Compared with patients who received usual care, patients assigned to the PEARLS intervention achieved lower depression severity (P<0.005) (Hopkins Symptoms Checklist-20) and lower suicidal ideation (P = 0.025) over 12 months.


CONCLUSIONS
The PEARLS program, a community-integrated, home-based treatment for depression, effectively reduces depressive symptoms in adults with epilepsy and comorbid depression.
Ciechanowski
Paul
P
Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98195-6560, USA. pavelcie@u.washington.edu
Chaytor
Naomi
N
Miller
John
J
Fraser
Robert
R
Russo
Joan
J
Unutzer
Jurgen
J
Gilliam
Frank
F
D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D057189:Checklist; D003153:Community Health Services; D003863:Depression / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology / Q000628:therapy*; D004827:Epilepsy / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D013997:Time Factors; D016896:Treatment Outcome
D000928:Antidepressive Agents