1. Targeted Self-Management of Epilepsy and Mental Illness for individuals with epilepsy and psychiatric comorbidity.
- Author
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Sajatovic, Martha, Tatsuoka, Curtis, Welter, Elisabeth, Perzynski, Adam T., Colon-Zimmermann, Kari, Van Doren, Jamie R., Bukach, Ashley, Lawless, Mary Ellen, Ryan, Eleanor R., Sturniolo, Katherine, and Lhatoo, Samden
- Subjects
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MENTAL illness , *HEALTH self-care , *DISEASE complications , *COMORBIDITY , *SEVERITY of illness index ,EPILEPSY research - Abstract
Objectives Serious mental illness is disproportionately common in people with epilepsy and contributes to complications and mortality. Few care approaches specifically target individuals who have epilepsy and severe mental illness. We used an iterative process to refine an existing intervention and tested the novel intervention, T argeted Self-Management for Ep i lepsy and Me ntal Illness (TIME) in individuals with epilepsy and comorbid mental illness (E-MI). Methods The TIME intervention was developed with input from a community advisory board and then tested for feasibility, acceptability, and preliminary efficacy in people with E-MI, using a 16-week prospective, randomized controlled design comparing TIME (N = 22) vs. treatment as usual (TAU, N = 22). Primary outcome was change in depressive symptoms, assessed by the Montgomery Asberg Depression Rating Scale (MADRS). Secondary assessments included global psychiatric symptom severity, seizure frequency, sleep patterns, quality of life, stigma, social support, and self-efficacy. Results There were 44 individuals enrolled, mean age 48.25 (SD = 11.82) with 25 (56.8%) African-Americans. The majority (N = 31, 70.5%) were unemployed, and most (N = 41, 95.5%) had annual income < U.S. $25,000. With respect to study retention, there were 36 individuals (18 in TIME, 18 in TAU) assessed at 12 weeks and 35 individuals (19 in TIME, 16 in TAU) assessed at 16 weeks. There was a significant effect for MADRS (p = 0.036; effect size of 0.70), with lower MADRS at 16 weeks in TIME, while TAU MADRS did not change. Differences between most secondary measures were not statistically significant. Significance The TIME intervention engages individuals to actively participate in self-management and can reduce depression in E-MI. Given the high morbidity and mortality associated with epilepsy complicated by serious mental illness, additional research is needed to better identify how TIME might be implemented in routine care settings. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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