Efficacy of psychological intervention in epilepsy management: a systematic review highlighting sampled gender.

Abstract

Psychological intervention in epilepsy offers advantages such as low cost, non-invasiveness, lack of serious side effects, and facilitation of patient’s participation. However, its principal role in the management of epilepsy is unclear. This paper systematically reviews the efficacy of psychological intervention in the management of epilepsy, identifies the most effective psychological technique for reduction of seizure and associated psychological disorders, highlights other epilepsy-related domain affected by psychological intervention and raises questions on the possible post-intervention reoccurrence of seizures or comorbid disorders. A review of randomized control trials and pre-test, post-test assessment reporting the efficacy of psychological interventions in epilepsy published between 1986 and 2020 was conducted. A total of 2988 articles were identified from a search of seven databases (PubMed, Medline, PsycInfo, Cochrane, Google Scholar, Clarivate, and Science Direct). Twenty-eight studies with population of 2,080 (male = 47.2%, female = 52.8%) met the inclusion criteria for this review. Among the reviewed studies, 60.7% i.e., 17 of 28 studies, reported significant decrease in the seizure frequency of People Living With Epilepsy (PLWE) after exposure to psychological intervention. Behavioral therapy (Progressive Muscle Relaxation) appeared to be most effective, bringing about the most significant decrements in seizure frequency with seizure control for up-to 24 months pos-intervention. In spite of the need for more studies in the area of epilepsy especially in Nigeria and Africa, findings from this study indicate that psychological intervention is effective as it can reduce seizure frequency, and address epilepsy-related behaviors that Anti-Epileptic Drugs (AED) or surgery alone cannot address.