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Kanesaki H, Watanabe K, Osugi K, Ohara H, Takada K, Kinoshita M. Utility of scratch art therapy in adult epilepsy patients with difficulties in social adaptation. Epileptic Disord 2023; 25:702-711. [PMID: 37518932 DOI: 10.1002/epd2.20127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 06/25/2023] [Accepted: 07/07/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVE Adult patients with epilepsy are confronted with significant psychological and psychosocial burdens. However, the role of psychological intervention to improve quality of life has not been fully established yet. The basis of art therapy is symbolic representations of inner experiences but patients may have difficulty expressing themselves. Here, we investigated utilities of scratch art therapy in Japanese adult patients with epilepsy who feel difficulties in social adaptation. METHODS Seven adult epilepsy patients (four males, age: 32.1 ± 9.9, mean ± SD) treated in epilepsy clinic of our hospital, who complained of psychosocial problems and underwent psychotherapy sessions combined with art therapy, were included. Six patients had focal epilepsy and two of them were sequelae of encephalitis. They were comorbid with depression, mood disorders, anxiety, memory disturbance, and insomnia. Psychotherapy sessions were scheduled at the same day of their clinic visit, every 4-12 weeks, 60 min per day, and art therapy was performed as a part (up to 30 min, in accord with the condition of the patient) of each session. Scratch art therapy was performed by using ready-made publications. Each patient selected favorite motives of figure out of several options suggested by the therapist. RESULTS All patients quickly adapted themselves to scratch art therapy and verbally expressed their hidden emotions during drawing. One female patient with emotional lability appealed that she could stab herself by pointed end of the pen. Three patients added self-motivated lines to the designed draft. Two patients realized problems to be solved and moved to other suitable therapeutic procedures. SIGNIFICANCE The current case series study demonstrated utilities of scratch art therapy in Japanese adult patients with epilepsy who feel difficulties in social adaptation. Scratch art therapy is easy to introduce in adult epilepsy patients who have trouble expressing themselves or have uncontrollable emotions.
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Affiliation(s)
- Hiromi Kanesaki
- Department of Rehabilitation, National Hospital Organization Utano National Hospital, Kyoto, Japan
| | - Kiwamu Watanabe
- Department of Neurology, Ayabe Renaiss Hospital, Ayabe, Japan
| | - Kazuha Osugi
- Department of Rehabilitation, National Hospital Organization Utano National Hospital, Kyoto, Japan
| | - Hiroya Ohara
- Department of Neurology, Minaminara General Medical Center, Yoshino, Japan
| | - Kozue Takada
- Department of Neurology, National Hospital Organization Utano National Hospital, Kyoto, Japan
| | - Masako Kinoshita
- Department of Neurology, National Hospital Organization Utano National Hospital, Kyoto, Japan
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Bonakdarpour B, Zhou G, Huang D, Vidano CT, Schuele S, Zelano C, Takarabe C. Calming effect of Clinically Designed Improvisatory Music for patients admitted to the epilepsy monitoring unit during the COVID-19 pandemic: a pilot study. Front Neurol 2023; 14:1206171. [PMID: 37731858 PMCID: PMC10507627 DOI: 10.3389/fneur.2023.1206171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 08/04/2023] [Indexed: 09/22/2023] Open
Abstract
Background Epilepsy monitoring requires simulating seizure-inducing conditions which frequently causes discomfort to epilepsy monitoring unit (EMU) patients. COVID-19 hospital restrictions added another layer of stress during hospital admissions. The purpose of this pilot study was to provide evidence that live virtual Clinically Designed Improvisatory Music (CDIM) brings relief to EMU patients for their psychological distress. Methods Five persons with epilepsy (PWEs) in the EMU during the COVID-19 lockdown participated in the study (average age ± SD = 30.2 ± 6 years). Continuous electroencephalogram (EEG) and electrocardiogram (EKG) were obtained before, during, and after live virtual CDIM. CDIM consisted of 40 minutes of calming music played by a certified clinical music practitioner (CMP) on viola. Post-intervention surveys assessed patients' emotional state on a 1-10 Likert scale. Alpha/beta power spectral density ratio was calculated for each subject across the brain and was evaluated using one-way repeated analysis of variance, comparing 20 minutes before, during, and 20 minutes after CDIM. Post-hoc analysis was performed using paired t-test at the whole brain level and regions with peak changes. Results Patients reported enhanced emotional state (9 ± 1.26), decrease in tension (9.6 ± 0.49), decreased restlessness (8.6 ± 0.80), increased pleasure (9.2 ± 0.98), and likelihood to recommend (10 ± 0) on a 10-point Likert scale. Based on one-way repeated analysis of variance, alpha/beta ratio increased at whole-brain analysis (F3,12 = 5.01, P = 0.018) with a peak in midline (F3,12 = 6.63, P = 0.0068 for Cz) and anterior medial frontal region (F3,12 = 6.45, P = 0.0076 for Fz) during CDIM and showed a trend to remain increased post-intervention. Conclusion In this pilot study, we found positive effects of CDIM as reported by patients, and an increased alpha/beta ratio with meaningful electroencephalographic correlates due to the calming effects in response to CDIM. Our study provides proof of concept that live virtual CDIM offered demonstrable comfort with biologic correlations for patients admitted in the EMU during the COVID-19 pandemic.
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Affiliation(s)
- Borna Bonakdarpour
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Feinberg School of Medicine, Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University, Chicago, IL, United States
| | - Guangyu Zhou
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Daniel Huang
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Feinberg School of Medicine, Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University, Chicago, IL, United States
| | - Catherine T. Vidano
- Feinberg School of Medicine, Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University, Chicago, IL, United States
| | - Stephan Schuele
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Christina Zelano
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Clara Takarabe
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Feinberg School of Medicine, Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University, Chicago, IL, United States
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Carrizosa Moog J. Psychological and social aspects of people with epilepsy expressed through drawing: Pilot study. Epilepsy Behav 2023; 145:109337. [PMID: 37392601 DOI: 10.1016/j.yebeh.2023.109337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/15/2023] [Accepted: 06/18/2023] [Indexed: 07/03/2023]
Abstract
INTRODUCTION Frequently, the psychological and social aspects of PWE go unnoticed in medical consultations. Even in spite of having seizure control, some people can experience a poor quality of life. The objective of the study was to determine if drawing facilitates the expression of the psychological and social difficulties of PWE. METHODS Hermeneutic, qualitative, situated knowledge study located in the city of Medellín, Colombia. The participants were asked to make one or several drawings under the question "what it is like to live with epilepsy". The drawings were analyzed with criteria of Gestalt psychology, semiotics, image-word relationship and context. RESULTS Sixteen drawings of ten participants were obtained. The drawings revealed the construction of an identity of otherness and negative emotionality due to epilepsy. The social concepts of restriction, prohibition, dependency, and exclusion appear in the drawings. The authors expose the ways to face adversity. CONCLUSION Drawing can expose and facilitate the expression of the psychological and social difficulties of PWE, which often go unnoticed in the medical office. Free drawing is an easy-to-use global tool that has been underused in the medical field.
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Affiliation(s)
- Jaime Carrizosa Moog
- Pediatric Department, University of Antioquia, Medellín, Colombia; Pediaciencias Research Group, Colombia; EAFIT University Medellín, Colombia.
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Mameniškienė R, Puteikis K, Carrizosa-Moog J. Neurology specialists’ visual interpretation of psychogenic nonepileptic seizures: Contemplating their etiology and existing challenges. Seizure 2021; 90:175-181. [DOI: 10.1016/j.seizure.2021.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 12/27/2020] [Accepted: 01/07/2021] [Indexed: 11/16/2022] Open
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Stafstrom CE. Using artwork to understand and address the psychosocial challenges facing children and adolescents with epilepsy. Epilepsy Behav 2019; 101:106572. [PMID: 31711867 DOI: 10.1016/j.yebeh.2019.106572] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 09/14/2019] [Indexed: 01/08/2023]
Abstract
Artwork is a valuable and underutilized technique for exploring the self-esteem and psychological challenges facing children and adolescents with epilepsy and other chronic diseases. Having children with epilepsy draw a picture of their seizure correlates reliably with seizure type, provides insight into the child's developmental level, and allows expression of inner feelings such as helplessness, vulnerability, and self-concept. Art therapy focus groups are beneficial in helping children with epilepsy express their feelings nonverbally and get to know peers facing similar challenges. On the occasion of Epilepsy and Behavior's 20th anniversary, this article reviews the usefulness of art for exploring the self-concept of patients with epilepsy and acknowledges the journal's support of this informative, inexpensive, and empowering adjunctive technique. "Special Issue: Epilepsy & Behavior's 20th Anniversary".
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Affiliation(s)
- Carl E Stafstrom
- Division of Pediatric Neurology, Department of Neurology, The Johns Hopkins Hospital and University School of Medicine, Baltimore, MD, United States of America.
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