New Psychological Treatment for Children with Epilepsy

A new psychological treatment for children with epilepsy created by a UCL-led team of scientists has been shown to reduce mental health difficulties when compared to normal care, according to a recent study.

Mental health issues such as anxiety, depression, and behavioral issues are more common in children and young people with brain conditions such as epilepsy than in the general population—up to 60% of those with epilepsy have associated mental health disorders, and many have more than one.

These diseases can significantly influence patients’ quality of life and overall health.

Currently, mental health problems in children and young people with epilepsy are frequently overlooked since epilepsy facilities are typically separate from those that address mental health issues. When mental health issues are detected, routine therapy for children with epilepsy is typically provided by professionals, such as child and adolescent mental health services (CAMHS) or hospital-based pediatric psychology services. The treatment often consists of treating each mental health disorder (e.g., anxiety, depression, behavioral issues) individually.

The new treatment, known as the Mental Health Intervention for Children with Epilepsy (MICE), is modeled after those recommended by the National Institute for Health and Care Excellence (NICE) for the treatment of common mental health issues, such as cognitive behavioral therapy for anxiety and depression. However, it employs a modular approach that allows numerous mental health disorders to be treated concurrently, rather than having separate therapies for distinct mental health difficulties.

It was also tailored expressly for children and young people with epilepsy, including sessions explaining the link between epilepsy and mental health.

Additionally, the treatment can be provided over the phone or via video call, eliminating the need for people to come to the hospital and miss time from school or work. And, rather than being outsourced to services like CAMHS, it is integrated into epilepsy services, which means it might be provided by non-mental health professionals.

Lead author Dr. Sophie Bennett, who conducted the research while working at UCL Great Ormond Street Institute of Child Health, stated, “This treatment breakthrough means that we now have a new way to help children and young people with epilepsy who also have mental health issues.”

“The treatment can be provided from within epilepsy services, allowing for more coordinated care. It does not have to be administered by a specialist mental health clinician, such as a psychologist. Integrating care can benefit epileptic children and their families in a more effective and efficient manner. We were very delighted that the benefits were maintained after treatment finished.”

The novel treatment, described in The Lancet, was developed in collaboration with young people and their families, as well as health-care professionals such as doctors, nurses, and psychologists.

Patients had an initial assessment, followed by weekly phone sessions with the clinician, although face-to-face therapy was offered if desired. The sessions were presented to the young person directly or through their caregiver, depending on their specific circumstances.

Researchers tested the treatment on 334 children and young people aged three to eighteen. 166 of these received the novel MICE treatment, whereas 168 received standard care for mental health issues in epileptic youngsters.

They evaluated teenagers’ mental health and overall well-being using a parent-reported Strengths and Difficulties Questionnaire (SDQ), which included questions about emotional difficulties, conduct, hyperactivity, and peer problems.

The findings revealed that children who received the MICE treatment had fewer mental challenges than those who received standard care, resulting in a 40% drop in the probability of having a psychiatric disease.

Co-Chief Investigator Professor Roz Shafran (UCL Great Ormond Street Institute of Child Health and GOSH) stated, “These groundbreaking discoveries not only promise improved futures for children with epilepsy, but also pave the path for a fundamental shift in mental health treatment methods. The united efforts of scientists, patients, and health care providers have resulted in a new age of therapy for mental health difficulties connected with epilepsy, providing a light of hope for families facing these challenges.

Professor Helen Cross (UCL Great Ormond Street Institute of Child Health and GOSH), co-chief investigator, said, “This study shows real progress for clinicians considering the high rate of mental health problems in children with epilepsy, as we demonstrate the benefit of a therapy that can be implemented within existing epilepsy services.”

Professor Isobel Heyman (UCL Great Ormond Street Institute of Child Health and Clinical Co-Lead for Mental Health at Cambridge Children’s Hospital) commented, “These promising results show that staff working in pediatric settings can be trained to deliver effective mental health treatment to children with a physical health condition (epilepsy).” It clearly indicates that children’s health care needs may be handled in a holistic manner to serve the “whole child” in the same place at the same time.”

The study was carried out in partnership with experts from Great Ormond Street Children’s Hospital (GOSH), King’s College London, and UCLA.

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