Mindfulness Therapies in the Management of Epilepsy

Abstract

Purpose/Objective: Mental health comorbidities are frequent and severe for people with epilepsy. Although psychological interventions, such as mindfulness, have been piloted questions about their effectiveness and potential adverse effects of regular mindful practice remain. This review provides an up-to-date evaluation of controlled research in this area. Methods: The Embase, PsycINFO, PubMed, Scopus and Web of Science databases were searched for mindfulness studies that evaluated psychological outcomes in adults with epilepsy. The reporting quality of retrieved studies was assessed (QualSyst tool) and standardised mean group differences (Hedges’ g), with 95% confidence intervals and p values calculated. The results were narratively synthesised. Results: Eight randomised controlled trials (Nparticipants= 783), primarily involving adults with generalised onset seizures, were included. All studies had sound methodological quality. A combination of group and individual mindfulness therapies delivered face-toface, via telephone and/or online, were examined. Medium to very large gains across psychological outcomes were associated with Mindfulness-Based Cognitive Therapy and Acceptance and Commitment Therapy (grange= 2.417 to 0.232, p <.05). Continued improvements in quality of life were reported at 12-month follow-up (grange= .269 to 1.58). Although no adverse effects of mindfulness were noted, these data were not routinely reported (Nstudies= 3). Conclusions: There is preliminary evidence to suggest that mindfulness can bring positive psychological effects for people living with epilepsy. Future controlled trials are needed to clarify the facilitating effects of mindfulness therapies in the seizure process as well as practical issues surrounding their implementation and delivery across clinical settings.