Milena Gandy1, Avani C Modi2, Janelle L Wagner3, W Curt LaFrance4, Markus Reuber5, Venus Tang6,7, Kette D Valente8, Laura H Goldstein9, Kirsten A Donald10, Genevieve Rayner11, Rosa Michaelis12,13. 1. The eCentreClinic, Department of Psychology, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia. 2. Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA. 3. College of Nursing, Medical University of South Carolina, Charleston, SC, USA. 4. Departments of Psychiatry and Neurology, Rhode Island Hospital, Brown University, Providence, RI, USA. 5. Academic Neurology Unit, Royal Hallamshire Hospital, University of Sheffield, Sheffield, UK. 6. Department of Clinical Psychology, Prince of Wales Hospital, Hospital Authority, Sha Tin, Hong Kong. 7. Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Chinese University of Hong Kong, Shatin, Hong Kong. 8. Department of Psychiatry, Faculty of Medicine, University of Sao Paulo (HCFMUSP), Sao Paulo, Brazil. 9. Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. 10. Division of Developmental Paediatrics, Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and the Neuroscience Institute, University of Cape Town, Cape Town, South Africa. 11. Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia. 12. Department of Neurology, Gemeinschaftskrankenhaus Herdecke, University of Witten/Herdecke, Herdecke, Germany. 13. Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Ruhr-University Bochum, Bochum, Germany.
Abstract
Objectives: The Psychology Task Force of the Medical Therapies Commission of the International League Against Epilepsy (ILAE) has been charged with taking steps to improve global mental health care for people with epilepsy. This study aimed to inform the direction and priorities of the Task Force by examining epilepsy healthcare providers' current practical experiences, barriers, and unmet needs around addressing depression and anxiety in their patients. Methods: A voluntary 27-item online survey was distributed via ILAE chapters and networks. It assessed practices in the areas of screening, referral, management, and psychological care for depression and anxiety. A total of 445 participants, from 67 countries (68% high income), commenced the survey, with 87% completing all components. Most respondents (80%) were either neurologists or epileptologists. Results: Less than half of respondents felt adequately resourced to manage depression and anxiety. There was a lack of consensus about which health professionals were responsible for screening and management of these comorbidities. About a third only assessed for depression and anxiety following spontaneous report and lack of time was a common barrier (>50%). Routine referrals to psychiatrists (>55%) and psychologists (>41%) were common, but approximately one third relied on watchful waiting. A lack of both trained mental health specialists (>55%) and standardized procedures (>38%) was common barriers to referral practices. The majority (>75%) of respondents' patients identified with depression or anxiety had previously accessed psychotropic medications or psychological treatments. However, multiple barriers to psychological treatments were endorsed, including accessibility difficulties (52%). Significance: The findings suggest that while the importance of managing depression and anxiety in patients with epilepsy is being recognized, there are ongoing barriers to effective mental health care. Key future directions include the need for updated protocols in this area and the integration of mental health professionals within epilepsy settings.
Objectives: The Psychology Task Force of the Medical Therapies Commission of the International League Against Epilepsy (ILAE) has been charged with taking steps to improve global mental health care for people with epilepsy. This study aimed to inform the direction and priorities of the Task Force by examining epilepsy healthcare providers' current practical experiences, barriers, and unmet needs around addressing depression and anxiety in their patients. Methods: A voluntary 27-item online survey was distributed via ILAE chapters and networks. It assessed practices in the areas of screening, referral, management, and psychological care for depression and anxiety. A total of 445 participants, from 67 countries (68% high income), commenced the survey, with 87% completing all components. Most respondents (80%) were either neurologists or epileptologists. Results: Less than half of respondents felt adequately resourced to manage depression and anxiety. There was a lack of consensus about which health professionals were responsible for screening and management of these comorbidities. About a third only assessed for depression and anxiety following spontaneous report and lack of time was a common barrier (>50%). Routine referrals to psychiatrists (>55%) and psychologists (>41%) were common, but approximately one third relied on watchful waiting. A lack of both trained mental health specialists (>55%) and standardized procedures (>38%) was common barriers to referral practices. The majority (>75%) of respondents' patients identified with depression or anxiety had previously accessed psychotropic medications or psychological treatments. However, multiple barriers to psychological treatments were endorsed, including accessibility difficulties (52%). Significance: The findings suggest that while the importance of managing depression and anxiety in patients with epilepsy is being recognized, there are ongoing barriers to effective mental health care. Key future directions include the need for updated protocols in this area and the integration of mental health professionals within epilepsy settings.
Authors: Marco Mula; Esper Cavalheiro; Alla Guekht; Andres M Kanner; Hyang Woon Lee; Çiğdem Özkara; Alfredo Thomson; Sarah J Wilson Journal: Epileptic Disord Date: 2017-06-01 Impact factor: 1.819
Authors: Kirsten M Fiest; Scott B Patten; K Chelsea Altura; Andrew G M Bulloch; Colleen J Maxwell; Samuel Wiebe; Sophia Macrodimitris; Nathalie Jetté Journal: Epilepsy Behav Date: 2014-09-07 Impact factor: 2.937
Authors: Elizabeth A Beverly; Om P Ganda; Marilyn D Ritholz; Yishan Lee; Kelly M Brooks; Nina F Lewis-Schroeder; Masakazu Hirose; Katie Weinger Journal: Diabetes Care Date: 2012-05-22 Impact factor: 19.112