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Evaluation of the efficacy of behavioral psychotherapy compared to pharmacotherapy in the treatment of depressive disorder in Temporal Lobe Epilepsy with Hippocampal Sclerosis

Grant number: 19/26960-7
Support type:Scholarships in Brazil - Doctorate
Effective date (Start): September 01, 2020
Effective date (End): April 30, 2024
Field of knowledge:Health Sciences - Medicine - Psychiatry
Principal researcher:Kette Dualibi Ramos Valente
Grantee:Ellen Marise Lima
Home Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil

Abstract

Depressive Disorder (DD) is the most frequent psychiatric comorbidity in Temporal Lobe Epilepsy with Hippocampal Sclerosis (TLE-HS). It is associated with worse quality of life and cognitive impairment. There is limited evidence regarding the treatment of depression in people with epilepsy. This study aims to compare behavioral psychotherapeutic intervention, using behavioral activation, with drug treatment in a group of patients with TLE-HS and DD. The primary outcome measures will be depression severity, quality of life, and social adjustment. The following secondary outcome measures will be adopted: neuropsychological functioning, coping repertoire and social skills, frequency of epileptic seizures, adherence to treatment, and reporting of anti-epileptic drugs. In this prospective, randomized, single-blind, and controlled trial, 50 patients diagnosed with TLE-HS and diagnosed with DD will be evaluated. All patients will undergo psychiatric and neurological screening. The participants will be divided into two groups: (1) Experimental Group (EG), which will undergo psychotherapeutic intervention, and (2) Control Group (CG), that will receive the usual drug treatment. For EG, a behavioral psychotherapy treatment program based on Behavioral Activation was developed. The treatment comprises 12 one-hour sessions, performed weekly. After the end of the treatment period, a maintenance session will be held for six months until the end of the study.The CG will receive the protocol suggested by the APA guidelines for the treatment of DD (selective serotonin reuptake inhibitor - sertraline). For both groups, outcome measures will be systematically evaluated with valid and reliable criteria at the following time intervals: baseline (before intervention); after the 6th intervention session; soon after the end of treatment; three and six months after the end of treatment. (AU)