Stress regulation in drug-resistant epilepsy

• Published in: Epilepsy & behavior Vol. 71; no. Pt A; pp. 39 - 50
• Main Authors: Kotwas, Iliana, McGonigal, Aileen, Bastien-Toniazzo, Mireille, Bartolomei, Fabrice, Micoulaud-Franchi, Jean-Arthur
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2017; [San Diego CA]: Elsevier B.V
• Subjects: Adult; Anxiety disorders; Anxiety Disorders - epidemiology; Anxiety Disorders - psychology; Anxiety Disorders - therapy; Biofeedback; CBT; Chronic Disease; Cognitive science; Comorbidity; Depressive disorders; Drug Resistant Epilepsy - epidemiology; Drug Resistant Epilepsy - psychology; Drug Resistant Epilepsy - therapy; Female; Humans; Life Sciences; Mindfulness; Neurology; Quality of Life; Screening of comorbidities; Seizures - epidemiology; Seizures - psychology; Seizures - therapy; Self-Control; Stress management; Stress, Psychological - epidemiology; Stress, Psychological - psychology; Stress, Psychological - therapy; Yoga; AED; Screening of comorbidities; PSC; LOC; Anxiety disorders; Temporal Lobe Epilepsy; Locus Of Control; Perceived Self-Control; GAD; MDD; TLE; Mindfulness; QOL; CBT; Quality of Life; Stress management; Yoga; Biofeedback; Anti Epileptic Drug; Generalized Anxiety Disorder; Patient With Epilepsy; Depressive disorders; Major Depressive Disorder; PWE
• ISSN: 1525-5050; 1525-5069
• DOI: 10.1016/j.yebeh.2017.01.025

Abstract The prevalence of psychological distress, especially depressive and anxiety disorders, is higher in epilepsy than in other chronic health conditions. These comorbid conditions contribute even more than epileptic seizures themselves to impaired quality of life in patients with epilepsy (PWE). The link between these comorbidities and epilepsy appears to have a neurobiological basis, which is at least partly mediated by stress through psychological and pathophysiological pathways. The impact of stress in PWE is also particularly important because it is the most frequently reported seizure trigger. It is therefore crucial for clinicians to take stress-related conditions and psychiatric comorbidities into account when managing PWE and to propose clinical support to enhance self-control of stress. Screening tools have been specially designed and validated in PWE for depressive disorders and anxiety disorders (e.g. NDDI-E, GAD-7). Other instruments are useful for measuring stress-related variables (e.g. SRRS, PSS, SCS, MHLCS, DSR-15, ERP-R, QOLIE-31) in order to help characterize the individual “stress profile” and thus orientate patients towards the most appropriate treatment. Management includes both pharmacological treatment and nonpharmacological methods for enhancing self-management of stress (e.g. mindfulness-based therapies, yoga, cognitive-behavioral therapies, biofeedback), which may not only protect against psychiatric comorbidities but also reduce seizure frequency.