Abstracts

Rationale: Felt stigma of people with epilepsy (PWE) may have significant impact on their outcome. The recognition of the factors affecting felt stigma may be critical to manage them. Affective symptoms, such as depression and anxiety, have been known to be risks for developing felt stigma. The purpose of this study was to identify how the psychosocial profiles of PWE affect felt stigma in epilepsy. Methods: The study included consecutive PWE who took antiepileptic drugs (AEDs) for more than 1 year and attended the epilepsy clinic of Department of Neurology of Gyeongsang National University Hospital from April 17, 2011 to May 20, 2011. They were asked to complete self-report questionnaires, including Korean versions of the Questionnaire for Felt Stigma, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Scale for Suicide Ideation (SSI-Beck), Quality of Life in Epilepsy Inventory-31 (QOLIE-31), and total Adverse Event Profile (AEP). Demographic and clinical data were collected by the review of medical records. We divide the patients into two groups PWE with felt stigma and PWE without felt stigma . Psychosocial and clinico-demographic factors including BDI score, BAI score, SSI-Beck scores, QOLIE-31, total AEP scores, age, onset age, sex, education duration, epilepsy duration, AED medication duration, AED combination, etiological classification, type of epilepsy, drug response, employment status, economic status, and marital status were compared between the two groups. Results: Forty-nine PWE (age 38.8 14.4 years, 69.4% males) were included in the study. Twenty of 49 PWE (40.8%) reported felt stigma and 11 of 49 PWE (22.4%) answered yes in all 3 items. Univariate analysis showed that several variables were significantly associated with the presence of felt stigma in PWE. They were higher BDI score (p < 0.001), higher BAI score (p = 0.005), higher SSI-Beck score (p = 0.049), lower QOLIE-31 score (p < 0.001), and higher total AEP score (p = 0.001). The tendencies of drug-resistance and longer education duration were observed more in PWE with felt stigma than those without felt stigma (p = 0.079 in both). Multivariate analysis using binary logistic regression was performed with the variables which had been significant (p < 0.05) in univariate analysis. Binary logistic regression analysis revealed that only higher BDI score was independently associated with felt stigma (p = 0.006). The tendencies of higher SSI-Beck score was observed more in PWE with felt stigma than those without felt stigma (p = 0.064). Other variables were not associated with felt stigma of PWE. Conclusions: This study confirmed that psychosocial profiles of PWE are important factors for development of felt stigma in PWE. Among the factors, depressive symptoms may be the most important factors contributing felt stigma of PWE. To reduce felt stigma, the recognition and evaluation of depression should be a part of management of PWE.