Bauer P.R.a· Bronnec M.L.A.a· Schulze-Bonhage A.b· Altenmüller D.-M.b· Fuchs T.c

Author affiliations

aPsychosomatic Medicine and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine, Freiburg, Germany
bEpilepsy Center, Department of Neurosurgery, Medical Center – University of Freiburg, Faculty of Medicine, Freiburg, Germany
cPhenomenological Psychopathology and Psychotherapy, Psychiatric Clinic, Heidelberg University, Heidelberg, Germany

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Article / Publication Details

Received: August 02, 2022
Accepted: December 28, 2022
Published online: March 16, 2023

Number of Print Pages: 13
Number of Figures: 0
Number of Tables: 2

ISSN: 0254-4962 (Print)
eISSN: 1423-033X (Online)

For additional information: https://www.karger.com/PSP

Abstract

Introduction: Mental health comorbidities such as depression and anxiety are common in epilepsy, especially among people with pharmacoresistant epilepsy who are candidates for epilepsy surgery. The Psychology Task Force of the International League Against Epilepsy advised that psychological interventions should be integrated into comprehensive epilepsy care. Methods: To better understand the psychological impact of epilepsy and epileptic seizures in epilepsy surgery candidates, we analysed interviews with this subgroup of patients using Karl Jaspers’ concept of limit situations, which are characterised by a confrontation with the limits and challenges of life. These are especially chance, randomness, and unpredictability, death and finitude of life, struggle and self-assertion, guilt, failure, and falling short of one’s aspirations. Results: In 43 interviews conducted with 15 people with drug-resistant epilepsy who were candidates for epilepsy surgery, we found that these themes are recurrent and have a large psychosocial impact, which can result in depression and anxiety. For some people, epileptic seizures appear to meet the criteria for traumatic events. Conclusion: Understanding epilepsy and seizures as existential challenges complements the neurobiological explanations for psychological comorbidities and can help tailor psychological interventions to the specific needs of people with epilepsy, especially those who are candidates for surgical treatment.

© 2023 S. Karger AG, Basel

References Fisher RS, Acevedo C, Arzimanoglou A, Bogacz A, Cross JH, Elger CE, et al. ILAE Official Report: a practical clinical definition of epilepsy. Epilepsia. 2014;55(4):475–82. Sultana B, Panzini M-A, Veilleux Carpentier A, Comtois J, Rioux B, Gore G, et al. Incidence and prevalence of drug-resistant epilepsy: a systematic review and meta-analysis. Neurology. 2021 Apr;96(17):805–17. Engel J. The current place of epilepsy surgery. Curr Opin Neurol. 2018 Apr;31(2):192–7. Kwan P, Arzimanoglou A, Berg AT, Brodie MJ, Allen Hauser W, Mathern G, et al. Definition of drug resistant epilepsy: consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies. Epilepsia. 2010 Jun;51(6):1069–77. Lu E, Pyatka N, Burant CJ, Sajatovic M. Systematic literature review of psychiatric comorbidities in adults with epilepsy. J Clin Neurol. 2021;17(2):176–86. Hellwig S, Mamalis P, Feige B, Schulze-Bonhage A, van Elst LT. Psychiatric comorbidity in patients with pharmacoresistant focal epilepsy and psychiatric outcome after epilepsy surgery. Epilepsy Behav. 2012 Mar;23(3):272–9. Reuber M, Andersen B, Elger CE, Helmstaedter C. Depression and anxiety before and after temporal lobe epilepsy surgery. Seizure. 2004;13(2):129–35. Pope RA, Thompson PJ, Rantell K, Stretton J, Wright M-A, Foong J. Frontal lobe dysfunction as a predictor of depression and anxiety following temporal lobe epilepsy surgery. Epilepsy Res. 2019 May;152:59–66. Chung MC, Allen RD. Alexithymia and posttraumatic stress disorder following epileptic seizure. Psychiatr Q. 2013 Sep;84(3):271–85. Soncin L-D, McGonigal A, Kotwas I, Belquaid S, Giusiano B, Faure S, et al. Post-traumatic stress disorder (PTSD) in patients with epilepsy. Epilepsy Behav. 2021 Aug;121(Pt A):108083. Mariotti S, Valentin D, Ertan D, Maillard L, Tarrada A, Chrusciel J, et al. Past trauma is associated with a higher risk of experiencing an epileptic seizure as traumatic in patients with pharmacoresistant focal epilepsy. Front Neurol. 2021 Jul;12:669411. Labudda K, Illies D, Bien CG, Neuner F. Postepileptic seizure PTSD: a very rare psychiatric condition in patients with epilepsy. Epilepsy Behav. 2018 Jan;78:219–25. Kanner AM, Schachter SC, Barry JJ, Hesdorffer DC, Mula M, Trimble M, et al. Depression and epilepsy: epidemiologic and neurobiologic perspectives that may explain their high comorbid occurrence. Epilepsy Behav. 2012 Jun;24(2):156–68. Hingray C, McGonigal A, Kotwas I, Micoulaud-Franchi J-A. The relationship between epilepsy and anxiety disorders. Curr Psychiatry Rep. 2019 Jun;21(6):40. Jacoby A, Ring A, Whitehead M, Marson A, Baker GA. Exploring loss and replacement of loss for understanding the impacts of epilepsy onset: a qualitative investigation. Epilepsy Behav. 2014 Apr;33:59–68. Velissaris SL, Wilson SJ, Saling MM, Newton MR, Berkovic SF. The psychological impact of a newly diagnosed seizure: losing and restoring perceived control. Epilepsy Behav. 2007 Mar;10(2):223–33. Ozanne A, Graneheim UH, Ekstedt G, Malmgren K. Patients’ expectations and experiences of epilepsy surgery-A population-based long-term qualitative study. Epilepsia. 2016 Apr;57(4):605–11. Michaelis R, Tang V, Goldstein LH, Reuber M, LaFrance WC, Lundgren T, et al. Psychological treatments for adults and children with epilepsy: evidence-based recommendations by the international League against epilepsy Psychology task force. Epilepsia. 2018;59(7):1282–302. Jaspers K. Philosophie II, existenzerhellung. 4th ed.Berlin/Heidelberg, New York: Springer; 1973. Jaspers K. Psychologie der Weltanschauungen. 3rd ed.Berlin: Springer; 1925. Fuchs T. Existential vulnerability: toward a psychopathology of limit situations. Psychopathology. 2013;46(5):301–8. Petitmengin C, Remillieux A, Valenzuela-Moguillansky C. Discovering the structures of lived experience. Phenomenol Cogn Sci. 2019 Sep;18(4):691–730. Petitmengin C. Describing one’s subjective experience in the second person: an interview method for the science of consciousness. Phenomenol Cogn Sci. 2006 Dec;5(3–4):229–69. Bronnec MLA, Altenmüller D-M, Fuchs T, Lahmann C, Schulze-Bonhage A, Bauer PR. What is this strange sensation?” A qualitative exploration of metaphors used to verbalise hard-to-describe experiences by people with epilepsy. Epilepsy Behav. 2023 Jan;138:108963. Ryvlin P, Nashef L, Lhatoo SD, Bateman LM, Bird J, Bleasel A, et al. Incidence and mechanisms of cardiorespiratory arrests in epilepsy monitoring units (MORTEMUS): a retrospective study. Lancet Neurol. 2013 Oct;12(10):966–77. Otoom S, Al-Jishi A, Montgomery A, Ghwanmeh M, Atoum A. Death anxiety in patients with epilepsy. Seizure. 2007 Mar;16(2):142–6. Rauh R, Schulze-Bonhage A, Metternich B. Assessment of anxiety in patients with epilepsy: a literature review. Front Neurol. 2022 Apr;13:836321. Bauer PR, Poletti S, Lutz A, Sabourdy C. Coping with seizures through mindfulness meditation: a qualitative study of a mindfulness-based intervention in epilepsy. Mindfulness. 2019 Oct;10(10):2010–25. Fuchs T. Temporality and psychopathology. Phenomenol Cogn Sci. 2013 Mar;12(1):75–104. Maier SF, Seligman MEP. Learned helplessness at fifty: insights from neuroscience. Psychol Rev. 2016 Jul;123(4):349–67. Hoppe C, Elger CE. Depression in epilepsy: a critical review from a clinical perspective. Nat Rev Neurol. 2011 Aug;7(8):462–72. Hermann BP. Psychopathology in epilepsy and learned helplessness. Med Hypotheses. 1979 Jun;5(6):723–9. Tarrada A, Aron O, Vignal JP, Ertan D, Maillard L, Hingray C. Anticipatory anxiety of seizures is associated with ictal emotional distress and amygdala onset seizures. Epilepsia. 2022 May;63(5):1130–40. Janak PH, Tye KM. From circuits to behaviour in the amygdala. Nature. 2015 Jan;517(7534):284–92. Boswell JF, Sharpless BA, Greenberg LS, Heatherington L, Huppert JD, Barber JP, et al. Schools of psychotherapy and the beginnings of a scientific approach. In: Barlow H, editor. The Oxford handbook of clinical psychology. Oxford University Press; 2010. p. 98–127. Schlimme JE. An existential understanding of psychotherapy and psychiatric practice. Psychopathology. 2013;46(5):355–62. Schubert CF, Schmidt U, Rosner R. Posttraumatic growth in populations with posttraumatic stress disorder: a systematic review on growth-related psychological constructs and biological variables. Clin Psychol Psychother. 2016;23(6):469–86. Frankl VE. Der unbewusste gott. 17th ed.DTV; 1992. Michaelis R, Niedermann C, Reuber M, Kuthe M, Berger B. Seizures have become a means of somehow learning things about myself”: a qualitative study of the development of self-efficacy and mastery during a psychotherapeutic intervention for people with epilepsy. Epilepsy Behav. 2018;84:152–61. Reiter JM, Andrews D, Reiter C, LaFrance WC. Taking control of your seizures. New York: Oxford University Press; 2015. Michaelis R, Schonfeld W, Elsas SM. Trigger self-control and seizure arrest in the Andrews/Reiter behavioral approach to epilepsy: a retrospective analysis of seizure frequency. Epilepsy Behav. 2012;23(3):266–71. Heinen G, Michaelis R, Elsas SM. Selbst Handeln bei Anfällen [Internet]. 2021 [cited 2022 December 13]. Available from: https://www.hippocampus.de/Selbst-Handeln.65593.html. Thompson NJ, Patel AH, Selwa LM, Stoll SC, Begley CE, Johnson EK, et al. Expanding the efficacy of Project UPLIFT: distance delivery of mindfulness-based depression prevention to people with epilepsy. J Consult Clin Psychol. 2015;83(2):304–13. Thompson NJ, Walker ER, Obolensky N, Winning A, Barmon C, Diiorio C, et al. Distance delivery of mindfulness-based cognitive therapy for depression: project UPLIFT. Epilepsy Behav. 2010 Nov;19(3):247–54. Tang V, Poon WS, Kwan P. Mindfulness-based therapy for drug-resistant epilepsy: an assessor-blinded randomized trial. Neurology. 2015;85(13):1100–7. Elsas SM, Gregory WL, White G, Navarro G, Salinsky MC, Andrews DJ. Aura interruption: the Andrews/Reiter behavioral intervention may reduce seizures and improve quality of life: a pilot trial. Epilepsy Behav. 2011;22(4):765–72. Janszky J, Szücs A, Rasonyi G, Schulz R, Hoppe M, Hollo A, et al. Intentional seizure interruption may decrease the seizure frequency in drug-resistant temporal lobe epilepsy. Seizure. 2004 Apr;13(3):156–60. Haut SR, Lipton RB, Cornes S, Dwivedi AK, Wasson RS, Cotton S, et al. Behavioral interventions as a treatment for epilepsy: a multicenter randomized controlled trial. Neurology. 2018;90(11):e963–70. Wolf P. From precipitation to inhibition of seizures: rationale of a therapeutic paradigm. Epilepsia. 2005;46(Suppl 1):15–6. Ormel J, Lindenberg S, Steverink N, Vonkorff M. Quality of life and social production functions: a framework for understanding health effects. Soc Sci Med. 1997 Oct;45(7):1051–63. Article / Publication Details

Received: August 02, 2022
Accepted: December 28, 2022
Published online: March 16, 2023

Number of Print Pages: 13
Number of Figures: 0
Number of Tables: 2

ISSN: 0254-4962 (Print)
eISSN: 1423-033X (Online)

For additional information: https://www.karger.com/PSP

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