Abstract
This study aimed to investigate the effect of a caregiver intensive education program (CIEP) on anxiety, depression, and quality of life (QOL) in patients with drug-resistant temporal lobe epilepsy and mesial temporal sclerosis (TLE-MTS) who underwent cortico-amygdalohippocampectomy (CAH). Ninety patients with drug-resistant TLE-MTS who underwent CAH and their caregivers were recruited and randomly allocated to the CIEP group or control group as 1:1 ratio. Caregivers received the CIEP program or routine guidance/education (control group). Anxiety/depression and QOL in patients at month (M)0, M1, M3, and M6 were assessed by the Hospital Anxiety and Depression Scale (HADS) scale and the QOL in Epilepsy Inventory-31 (QOLIE-31), respectively. Treatment efficacy at M6 was assessed by Engel classification. The HADS-anxiety score at M3 (P=0.049) and M6 (P=0.028), HADS-anxiety score change (M6-M0) (P=0.001), percentage of anxiety patients at M6 (P=0.025), and anxiety severity at M6 (P=0.011) were all decreased in the CIEP group compared with the control group. The HADS-depression score at M6 (P=0.033) and HADS-depression score change (M6-M0) (P=0.022) were reduced, while percentage of depression patients at M6 (P=0.099) and depression severity at M6 (P=0.553) showed no difference in the CIEP group compared with the control group. The QOLIE-31 score at M6 (P=0.043) and QOLIE-31 score change (M6-M0) (P=0.010) were both elevated in the CIEP group compared with the control group. In conclusion, CIEP for caregivers contributed to the recovery of anxiety and depression as well as the improvement of QOL in patients with drug-resistant TLE-MTS who underwent CAH.
Highlights
Epilepsy is a frequent brain disease caused by a disorder of the excitatory and inhibitory balance in the neuronal network, affecting more than 70 million people worldwide [1]
The caregiver intensive education program (CIEP) program was an educational program designed for the caregivers of patients with drugresistant Temporal lobe epilepsy and mesial temporal sclerosis (TLE-MTS), which started with a brief introduction of the program to both caregivers and patients and followed by a series of professional education of the disease, guidance of disease management, and help with problem solving and appointment scheduling among caregivers
We discovered that i) CIEP ameliorated anxiety and depression in patients; ii) CIEP improved quality of life (QOL) in patients; and iii) CIEP had less effect on improving treatment efficacy in patients
Summary
Epilepsy is a frequent brain disease caused by a disorder of the excitatory and inhibitory balance in the neuronal network, affecting more than 70 million people worldwide [1]. The refractory disease caused by drug resistance is a crucial issue in TLE-MTS treatment, and there is strong evidence showing that surgery is effective in treating refractory TLE-MTS, a high prevalence of post-surgery psychiatric disorder still occurs, which hampers the management of patients and blocks the way to a full recovery [3,4,5]. Management of psychiatric disorders in patients with drug-resistant TLEMTS who underwent surgery is urgently required. The caregivers, mostly consisting of families, relatives, and friends, play a determinant role in improving epilepsy patient outcomes. There is a report disclosing that factors related to caregivers, such as poor family relationship, caregiver depression, and caregiver unemployment could predict the patients’ mental health [6]
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