Abstracts

Rationale: Perceived stigma is a risk factor that hinders patients with chronic disease from participating in medical treatment and societal activities. In patients with epilepsy, perceived stigma affects multiple domains of their lives including medication adherence, affective aspects, and social participation. This study investigated the seizure-related and psychosocial indicators that may be impacted by epilepsy-related perceived stigma in adults with epilepsy. Methods: The sample consisted of 47 adults with epilepsy with the mean age of 34 years old (SD = 13.90). The mean age at epilepsy onset for this sample was 20 years old (SD = 16.42). All participants underwent comprehensive assessment including long-term video electroencephalogram monitoring, neuroimaging studies, and neuropsychological and psychiatric assessment at the Tohoku University Hospital Epilepsy Monitoring Unit. Data were obtained from medical records and self-report questionnaires. To measure perceived stigma, the Epilepsy Stigma Scale was used. The other variables included demographic and seizure-related variables, the Neurological Disorders Depression Inventory for Epilepsy, the Generalized Anxiety Disorder Assessment, and the Epilepsy Self-Efficacy Scale. Data were analyzed using Spearman's rank correlation coefficient test and Kruskal-Wallis rank sum test. Results: Approximately 36% patients indicated slight to strong epilepsy-related perceived stigma. Epilepsy-related perceived stigma was significantly correlated with the following: (a) seizure-related factors including the number of prescribed antiepileptic drugs (rs = .37, p < .05) and seizures frequency (rs= .35, p < .05); (b) affective conditions including anxiety (rs = .50, p < .01) and depression (rs = .31, p < .05); and (c) psychosocial factors which is epilepsy self-efficacy (rs = -.33, p < .05). The sample was further classified into three groups based on the current employment status: currently employed, previously employed, and never worked. Those who were previously employed showed significantly higher perceived stigma than those who never worked (p < .05). Moreover, patients with a history of receiving discrimination because of epilepsy indicated significantly higher perceived stigma than those without (p < .05). Conclusions: Epilepsy-related perceived stigma is associated not only with affective and psychosocial factors, but also with seizure-related variables. Patients who have participated in social activities like employment, are much more prone to perceive stigma attached to epilepsy. Hence, clinicians need to consider the impact of perceived stigma on both medical and psychosocial interventions of individual patients. Societal education is simultaneously crucial in reducing stigma and discrimination in order to enhance the role of individuals with epilepsy as active participants in the society. Further research is necessary to identify the protective factors against perceived stigma and develop interventions to improve patients' quality of life. Funding: JSPS KAKENHI Grant Number 15K15521