Mindfulness-based therapy for drug-resistant epilepsy: An assessor-blinded randomized trial.
OBJECTIVE
To investigate the effectiveness of mindfulness-based therapy (MT) and social support (SS) in patients with drug-resistant epilepsy.


METHODS
We performed an assessor-blinded randomized control trial. Sixty patients with drug-resistant epilepsy were randomly allocated to MT or SS (30 per group). Each group received 4 biweekly intervention sessions. The primary outcome was the change in the total score of the Patient-Weighted Quality of Life in Epilepsy Inventory (QOLIE-31-P). Secondary outcomes included seizure frequency, mood symptoms, and neurocognitive functions. The assessors were blinded to the patient's intervention grouping. Results were analyzed using general linear model with repeated measure.


RESULTS
Following intervention, both the MT (n=30) and SS (n=30) groups had an improved total QOLIE-31-P, with an improvement of +6.23 for MT (95% confidence interval [CI] +4.22 to +10.40) and +3.30 for SS (95% CI +1.03 to +5.58). Significantly more patients in the MT group had a clinically important improvement in QOLIE-31-P (+11.8 or above) compared to those who received SS (11 patients vs 4 patients). Significantly greater reduction in depressive and anxiety symptoms, seizure frequency, and improvement in delayed memory was observed in the MT group compared with the SS group.


CONCLUSIONS
We found benefits of short-term psychotherapy on patients with drug-resistant epilepsy. Mindfulness therapy was associated with greater benefits than SS alone in quality of life, mood, seizure frequency, and verbal memory.


METHODS
This study provides Class II evidence that mindfulness-based therapy significantly improves quality of life in patients with drug-resistant epilepsy.
From the Department of Clinical Psychology (V.T.), the Division of Neurosurgery, Department of Surgery, Faculty of Medicine (V.T., W.S.P.), and the Division of Neurology, Department of Medicine and Therapeutics, Faculty of Medicine (P.K.), Prince of Wales Hospital, The Chinese University of Hong Kong; and the Departments of Medicine and Neurology (P.K.), The University of Melbourne, Royal Melbourne Hospital, Australia. venustang@gmail.com.
Venus
V
Tang
From the Department of Clinical Psychology (V.T.), the Division of Neurosurgery, Department of Surgery, Faculty of Medicine (V.T., W.S.P.), and the Division of Neurology, Department of Medicine and Therapeutics, Faculty of Medicine (P.K.), Prince of Wales Hospital, The Chinese University of Hong Kong; and the Departments of Medicine and Neurology (P.K.), The University of Melbourne, Royal Melbourne Hospital, Australia.
Wai S
WS
Poon
From the Department of Clinical Psychology (V.T.), the Division of Neurosurgery, Department of Surgery, Faculty of Medicine (V.T., W.S.P.), and the Division of Neurology, Department of Medicine and Therapeutics, Faculty of Medicine (P.K.), Prince of Wales Hospital, The Chinese University of Hong Kong; and the Departments of Medicine and Neurology (P.K.), The University of Melbourne, Royal Melbourne Hospital, Australia.
Patrick
P
Kwan
D000328:Adult; D004351:Drug Resistance; D004827:Epilepsy / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D064866:Mindfulness / Q000379:methods*; D011615:Psychotherapy, Group / Q000379:methods; D011788:Quality of Life; D016037:Single-Blind Method; D012944:Social Support; D016896:Treatment Outcome