Managing depression and anxiety in people with epilepsy: A survey of epilepsy health professionals by the ILAE Psychology Task Force.
Managing depression and anxiety in people with epilepsy: A survey of epilepsy health professionals by the ILAE Psychology Task Force.
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DOI：
10.1002/epi4.12455
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发表时间：
2021-03
期刊：
影响因子：
3
通讯作者：
Michaelis R
中科院分区：
文献类型：
--
作者：
Gandy M;Modi AC;Wagner JL;LaFrance WC Jr;Reuber M;Tang V;Valente KD;Goldstein LH;Donald KA;Rayner G;Michaelis R
国际抗癫痫联盟（ILAE）医学治疗委员会的心理学工作组负责采取措施改善癫痫患者的全球精神卫生保健。这项研究旨在通过检查癫痫医疗服务提供者目前的实践经验，障碍和未满足的需求来了解工作组的方向和优先事项，以解决患者的抑郁和焦虑问题。通过ILAE分会和网络分发了一份自愿的27项在线调查。它评估了抑郁症和焦虑症的筛查、转诊、管理和心理护理方面的做法。共有来自67个国家的445名参与者（68%为高收入）开始了调查，其中87%完成了所有组成部分。大多数受访者（80%）是神经科医生或癫痫科医生。不到一半的受访者感到有足够的资源来管理抑郁和焦虑。对于哪些卫生专业人员负责筛查和管理这些合并症缺乏共识。大约三分之一的人在自发报告后只评估抑郁和焦虑，缺乏时间是一个常见的障碍（>50%）。常规转诊精神科医生（>55%）和心理学家（>41%）是常见的，但大约三分之一的人依赖于观察等待。缺乏训练有素的心理健康专家（>55%）和标准化程序（>38%）是转诊实践的常见障碍。大多数（>75%）被调查者的抑郁或焦虑患者以前曾接受过精神药物或心理治疗。然而，心理治疗存在多种障碍，包括可及性困难（52%）。研究结果表明，虽然癫痫患者管理抑郁和焦虑的重要性正在得到认可，但有效的心理健康护理仍存在障碍。未来的主要方向包括需要更新这一领域的协议，并将精神卫生专业人员纳入癫痫环境。
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. 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. 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%). 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.
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