title: Long-term outcomes from the PEARLS randomized trial for the treatment of depression in patients with epilepsy.
abstract: Depression is associated with higher rates of suicide and lower quality of life in individuals with epilepsy. We previously published the 12-month outcome from our randomized clinical trial of PEARLS (Ciechanowski P, Chaytor N, Miller J, et al. Epilepsy Behav. Epub 5 July 2010). The purpose of this study was to determine the long-term effectiveness of PEARLS, a home-based collaborative care intervention consisting of problem-solving treatment, behavioral activation, and psychiatric consultation, in individuals with epilepsy. Patients were randomly assigned to PEARLS (N=40) or usual care (N=40), and assessed at baseline and 6, 12, and 18 months. Patients assigned to PEARLS achieved lower depression severity (P<0.05) (Hopkins Symptoms Checklist-20), lower suicidal ideation (P<0.02), and better emotional well being (QOLIE-31) (P<0.02) over 18 months, compared with patients given the usual care. The PEARLS program significantly reduces depressive symptoms in adults with epilepsy, and this effect is maintained for 18 months after baseline and for more than 1 year after completion of home visits.
authors.affiliation: Department of Neurology, University of Washington School of Medicine, Seattle, WA, USA. chaytor@u.washington.edu
authors.forename: Naomi
authors.initials: N
authors.lastname: Chaytor
authors.forename: Paul
authors.initials: P
authors.lastname: Ciechanowski
authors.forename: John W
authors.initials: JW
authors.lastname: Miller
authors.forename: Robert
authors.initials: R
authors.lastname: Fraser
authors.forename: Joan
authors.initials: J
authors.lastname: Russo
authors.forename: Jurgen
authors.initials: J
authors.lastname: Unutzer
authors.forename: Frank
authors.initials: F
authors.lastname: Gilliam
mesh_terms: D000328:Adult; D003863:Depression / Q000209:etiology / Q000523:psychology / Q000628:therapy; D004644:Emotions / Q000502:physiology; D004827:Epilepsy / Q000150:complications*; D005260:Female; D006699:Home Care Services; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D013405:Suicide / Q000523:psychology; D013997:Time Factors; D016896:Treatment Outcome