Telephone-Based Support Programs for People With Epilepsy

The primary outcome is a dichotomous measure of depressive symptoms based on a Patient Health Questionnaire (PHQ-9) score of <5 versus ≥5. The PHQ-9 assesses depressive symptoms in the past two weeks. Total scores range from 0-27 with recommended cutoffs for mild (5-9), moderate (10-14), moderately severe (15-19) and severe (≥20) depressive symptoms. A PHQ-9 score of <5 indicates absence of clinically significant depressive symptoms.

The primary outcome is a dichotomous measure of depressive symptoms based on a Patient Health Questionnaire (PHQ-9) score of <5 versus ≥5. The PHQ-9 assesses depressive symptoms in the past two weeks. Total scores range from 0-27 with recommended cutoffs for mild (5-9), moderate (10-14), moderately severe (15-19) and severe (≥20) depressive symptoms. A PHQ-9 score of <5 indicates absence of clinically significant depressive symptoms.

The primary outcome is a dichotomous measure of depressive symptoms based on a Patient Health Questionnaire (PHQ-9) score of <5 versus ≥5. The PHQ-9 assesses depressive symptoms in the past two weeks. Total scores range from 0-27 with recommended cutoffs for mild (5-9), moderate (10-14), moderately severe (15-19) and severe (≥20) depressive symptoms. A PHQ-9 score of <5 indicates absence of clinically significant depressive symptoms.

The primary outcome is a dichotomous measure of depressive symptoms based on a Patient Health Questionnaire (PHQ-9) score of <5 versus ≥5. The PHQ-9 assesses depressive symptoms in the past two weeks. Total scores range from 0-27 with recommended cutoffs for mild (5-9), moderate (10-14), moderately severe (15-19) and severe (≥20) depressive symptoms. A PHQ-9 score of <5 indicates absence of clinically significant depressive symptoms.

Continuous PHQ-9 scores will be used to evaluate the magnitude of change in depressive symptoms. The PHQ-9 consists of nine questions that ask respondents how often they've "been bothered by any of the following problems" in the past two weeks. The questions address sleep, energy, appetite, and other possible symptoms of depression. Scores are calculated based on how frequently a person experiences these feelings. Score of 1-4 is considered minimal depression; score of 5-9 is considered mild depression; score of 10-14 is considered moderate depression; score of 15-19 is considered moderately severe depression; score of 20-27 is considered severe depression.

This will be assessed by self-reported 30-day seizure counts.

This will be assessed by a 12-item version of the Liverpool Seizure Severity Scale. The possible scoring ranges are between 7 and 32 for the percept scale and between 10 and 48 for the ictal/postictal scale. The higher the score the more severe the seizures.

This will be assessed by the Quality of Life in Epilepsy-10 (QOLIE-10) questionnaire, a 10-item measure of epilepsy-specific aspects of qualify of life. The QOLIE-10-P is a brief survey of health-related quality of life for adults with epilepsy. There are 10 questions about health and daily activities, one question about how much distress you feel about problems and worries related to epilepsy, and a review of what bothers you most.

This will be assessed by the Patient-Reported Outcomes Measurement Information System (PROMIS-10) questionnaire, a 10-item measure of global health (physical, mental and social functioning) developed by NIH as an indicator for Healthy People 2020. The PROMIS Global-10 is a 10-item patient-reported questionnaire in which the response options are presented as 5-point (as well as a single 11-point) rating scales. The results of the questions are used to calculate two summary scores: a Global Physical Health Score and a Global Mental Health score. These scores are then standardized to the general population, using the "T-Score". The average "T-Score" for the United States population is 50 points, with a standard deviation of 10 points. Higher scores indicate a healthier patient.

This will be assessed by the Interpersonal Support Evaluation List, a 12-item measure of the perceived availability of social support resources (appraisal, belonging, tangible support). The ISEL-12 can be scored by summing the items to create an overall social support score; three subscale scores representing appraisal, belonging, and tangible social support have also been proposed.

This will be assessed by the Five Facet Mindfulness Questionnaire Short Form, a 15-item measure that assesses five dimensions of trait mindfulness: observing, describing, acting with awareness, non-judging of inner experience and non-reactivity to inner experience. The following is the scoring information: Observing items: 1, 6, 11; Describe items: 2, 7R, 12 ; Acting with awareness items: 3R, 8R, 13R ; Non-judging items: 4R, 9R, 14R; Non-reactivity items: 5, 10, 15.

This will be assessed by the Ruminative Responses Scale, a 22-item measure that assesses how often participants engage in ruminative behaviors and cognitions in response to feeling sad or depressed.Each item are rated on a 4-point Likert scale ranging from 1 (never) to 4 (always). The total score ranges from 22 to 88, with higher scores indicating higher degrees of ruminative symptoms.

This will be assessed by the Perceived Stress Scale, a 10-item measure of the degree which situations in one's life are appraised as overwhelming, uncontrollable and unpredictable over the last month. The Perceived Stress Scale (PSS) is a classic stress assessment instrument. Scores ranging from 0-13 would be considered low stress. Scores ranging from 14-26 would be considered moderate stress. Scores ranging from 27-40 would be considered high perceived stress.

This will be assessed by the Generalized Anxiety Disorder-7 Scale, a 7-item measure of anxiety symptoms in the past two weeks that is used to screen for clinically significant anxiety. This is calculated by assigning scores of 0, 1, 2, and 3 to the response categories, respectively, of "not at all," "several days," "more than half the days," and "nearly every day." GAD-7 total score for the seven items ranges from 0 to 21. The higher the score, the greater the anxiety

This will be assessed by the Epilepsy Self-Management Scale, a 38-item measure of the frequency of use of epilepsy self-management behaviors. The ESMS scores range from 38 to 190, with higher scores reflecting an increased utilization of epilepsy self-management techniques.

This will be assessed by the Self-Compassion Scale, a 12-item measure of thoughts, emotions and behaviors associated with self-compassion. Average overall self-compassion scores tend to be around 3.0 on the 1-5 scale, a score of 1-2.5 indicates low self-compassion, 2.5-3.5 indicates moderate self-compassion and 3.5-5.0 means high self compassion.

Self-reported outpatient (neurology/epilepsy and primary care/other specialist) and inpatient encounters will be obtained at each study visit.