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- Ahorsu, Daniel Kwasi, et al.
(författare)
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Testing an app-based intervention to improve insomnia in patients with epilepsy : A randomized controlled trial
- 2020
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Ingår i: Epilepsy & Behavior. - : Elsevier BV. - 1525-5050 .- 1525-5069. ; 112
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Insomnia has adverse effects on people with epilepsy. We aimed to test a novel cognitive behavioral therapy for insomnia (CBT-I) app-based intervention on insomnia symptoms and social psychological factors in people with epilepsy and to examine the possible mechanisms among the factors.Methods: Participants were recruited from neurology clinics in Iran and comprised individuals diagnosed with epilepsy and having moderate to severe insomnia. A two-arm randomized controlled trial design was used, consisting of a treatment group (CBT-I; n = 160) and control group (patient education; n = 160). Primary outcomes were self-reported sleep quality, insomnia severity, and sleep hygiene behavior and objective sleep characteristics measured by actigraphy. Secondary outcomes were attitude, perceived behavioral control, intention, action planning, coping planning, behavioral automaticity, self-monitoring, anxiety, depression, and quality of life (QoL). All outcomes were measured at baseline, and at one, three, and six months postintervention, except objective sleep, which was assessed at baseline, and one and six months postintervention. Data were analyzed using linear mixed models.Results: Current findings showed that sleep quality, insomnia severity, sleep hygiene behavior, and sleep onset latency were significantly improved in the CBT-I group compared with the patient education group at all measurement points. Also, the CBT-I group had significantly improved anxiety, depression, and QoL compared with the patient education group. Mediation analyses showed that attitude, intention, coping planning, self-monitoring, and behavioral automaticity significantly mediated the effect of the intervention on sleep outcomes.Conclusion: Results support the use of the CBT-I app to improve sleep outcomes among people with epilepsy.
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| 2. |
- Arzy, Shahar, et al.
(författare)
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Neural generators of psychogenic seizures: Evidence from intracranial and extracranial brain recordings
- 2014
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Ingår i: Epilepsy & Behavior. - : Elsevier BV. - 1525-5069 .- 1525-5050. ; 31, s. 381-385
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Tidskriftsartikel (refereegranskat)abstract
- Psychogenic seizures (PSs) convincingly mimic seizure phenomena but with no underlying epileptic activity. However, not much is known about their neurophysiological basis. We had the rare opportunity to analyze intracranial brain recordings of PSs occurring besides epileptic seizures (ESs), which identified distinct frequency changes over the parietal cortex. For further validation, we applied topographic frequency analysis to two other patients who presented PSs and ESs during long-term monitoring. The analysis revealed a power decrease in the theta band at the posterior parietal cortex in all three patients during PSs but not during ESs. These changes may reflect disturbed self-referential processing associated with some PSs. (C) 2013 Elsevier Inc. All rights reserved.
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| 5. |
- Bjurulf, Björn, 1962, et al.
(författare)
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Caregiver reported behavior, sleep and quality of life in children with Dravet syndrome: A population-based study
- 2024
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Ingår i: Epilepsy and Behavior. - 1525-5050 .- 1525-5069. ; 150
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this population-based study was to assess behavior, sleep, and quality of life, and explore factors associated with these in children with Dravet syndrome. Methods: The Developmental Behavior Checklist, the Insomnia Severity Index, and a global question regarding quality of life from the Epilepsy and Learning Disabilities Quality of Life scale were completed by primary caregivers of 42/48 Swedish children with Dravet syndrome, born 2000–2018. Factors associated with problems with insomnia, behavior and quality of life were analyzed using multivariable linear regression. Results: Scores indicating significant behavioral problems were seen in 29/40 (72 %) children, scores indicating moderate or severe clinical insomnia in 18/42 (43 %) and scores indicating poor or very poor quality of life in 7/41 (17 %). On multivariable analysis, autistic symptoms were significantly associated with behavioral problems (p = 0.013), side-effects of anti-seizure medications (ASMs) were associated with insomnia (p = 0.038), whilst insomnia was significantly associated with poor quality of life (p = 0.016). Significance: Dravet syndrome in children is associated with significant problems with behavior, sleep and quality of life. There is a need to optimize treatment via ASMs and develop and evaluate interventions to treat behavioral and sleep difficulties to optimize outcomes.
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| 6. |
- Blomberg, Karin, 1970-, et al.
(författare)
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Fifty-year follow-up of childhood epilepsy : Social, psychometric, and occupational outcome
- 2019
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Ingår i: Epilepsy & Behavior. - : Elsevier. - 1525-5050 .- 1525-5069. ; 96, s. 224-228
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The objective of this study was to explore and describe the experience of a childhood diagnosis of epilepsy and its consequences for the experiences of daily life over a span of 50 years.METHODS: A descriptive mixed method design was chosen. Data were collected through a survey returned by 86 persons (59% response rate) who had received diagnoses of epilepsy as children. The survey contained questions about education, vocation, family status, and included the 14-item Hospital Anxiety and Depression Scale (HAD). Additionally, interviews (n = 11) were conducted and analyzed by interpretative description.RESULTS: Few persons reported that the childhood diagnosis of epilepsy had affected their choice of education, work, or leisure activities. However, 20% reported that the diagnosis had caused problems in school or at work and had restricted their activities of daily living. Sixty-six percent of the participants were married, and 68% had children; of those, 12 (20%) reported that one or more of the children had also had seizures. Almost all reported no anxiety (82%) and no depression (90%). The results of the interviews revealed a balancing act between 'Controlling and managing the situation' and 'Not being restricted by the condition'.SIGNIFICANCE: This long-term follow-up over a 50-year life-span of persons who received childhood diagnoses of epilepsy suggests that the consequences for education, work, and leisure activities were few. Most of the participants had developed strategies to manage their situation.
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| 9. |
- Cardeña, Etzel, et al.
(författare)
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Differentiating psychogenic nonepileptic from epileptic seizures: A mixed-methods, content analysis study
- 2020
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Ingår i: Epilepsy & Behavior. - : Elsevier BV. - 1525-5069 .- 1525-5050. ; 109
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Tidskriftsartikel (refereegranskat)abstract
- Background: Identification of clinical features that might distinguish psychogenic nonepileptic seizures (PNES)from epileptic seizures (ES) is of value for diagnosis, management, and understanding of both conditions. Previousstudies have shown that patients' descriptions of their seizures reflect differences in content and delivery.Weaimed to compare verbal descriptions of PNES and ES using a mixed-methods approach.Methods: We analyzed data from semi-structured interviews in which patients with video-electroencephalography(EEG)-confirmed ES (n=30) or PNES (n=10) described their seizures. Two masked raters independentlycoded the transcripts for relevant psychological categories and discrepancies that were noted and resolved. Additionalanalyses were conducted using the Linguistic Inquiry and Word Count system. The identified phenomenawere descriptively compared, and inferential analyses assessed group differences in frequencies. A logisticregression analysis examined the predictive power of the most distinctive phenomena for diagnosis.Results: As compared with ES, PNES reported longer seizures, more preseizure negative emotions (e.g., fear), anxietysymptoms (e.g., arousal, hyperventilation), altered vision/olfaction, and automatic behaviors. During seizures,PNES reported more fear, altered breathing, and dissociative phenomena (depersonalization, impairedtime perception). Epileptic seizures reported more self-injurious behavior. Postseizure, PNES reported morefear and weeping and ES more amnesia and aches. The predictive power when including these variables was97.5%. None of the single predictor variables was significant. The few but consistent linguistic differences relatedto the use of some pronouns and references to family.Conclusions: Although no single clinical feature definitively distinguishes PNES from ES, several features may besuggestive of a PNES diagnosis, including longer duration, negative emotion (i.e., fear) throughout the events,preseizure anxiety, ictal dissociation, and postseizure weeping. Fewer reports of ictal self-injury and postseizureamnesia and aches may also indicate the possibility of PNES.
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| 10. |
- Compagno Strandberg, Maria, et al.
(författare)
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Validation of the Swedish version of the Beliefs about Medicines Questionnaire, based on people with epilepsy
- 2021
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Ingår i: Epilepsy and Behavior. - : Elsevier BV. - 1525-5050 .- 1525-5069. ; 115
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Tidskriftsartikel (refereegranskat)abstract
- Title: Validation of the Swedish version of the Beliefs about Medicines Questionnaire, based on people with epilepsy. Purpose: The aims of the study were to explore the latent structure of the Swedish Beliefs about Medicines Questionnaire (BMQ), to investigate its reliability and to identify the extent to which individual factors among people with epilepsy (PWE), as well as their general beliefs about medication, predict their beliefs about their specific anti-seizure drugs (ASDs). Methods: One-hundred and fifty six included study participants diagnosed with epilepsy and with a well-established neurological follow-up completed an array of rating scales. Included were the Swedish BMQ, which captures beliefs about medicines, scales for symptoms of anxiety and depression and sense of self-efficacy, as well as a general questionnaire regarding their social situation in general. Statistical analysis included Principal Component Analyses (PCA) and hierarchical multiple regression analysis. Results: The PCA revealed a two-factor structure for each of the BMQ-subscales with acceptable (BMQ-G) to high (BMQ-S) internal consistency. The only individual factor that predicted variance in beliefs about medication was patient gender, where levels of both anxiety and depression were elevated in women. Conclusion: The Swedish BMQ exhibits psychometric features indicating its reliable use in adult PWE. Our results suggest that the BMQ provides information about the patients’ view of their medication regardless of their general mood and that women hold stronger beliefs of concern beyond influence from their levels of depression and anxiety.
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