Stigma in Patients with Drug Refractory Epilepsy: the Risk Factor, Psychiatric Comorbidities, and Quality of Life

Lee, Jong Mok; Song, Hyun Seok; Hwang, Yang Ha; Lee, Ho Won; Suh, Chung Kyu; Park, Sung Pa; Kwon, Soon Hak

Abstract

PURPOSE
Stigma is more likely to be reported by people with epilepsy with frequent seizures and associated with various physical and psychosocial factors. We determined risk factors associated with stigma, and investigated the impact of felt stigma on psychiatric comorbidities and quality of life (QOL) in patients with drug refractory epilepsy (DRE).
METHODS
Patients with DRE of partial onset, who experienced a failure of at least two antiepileptic drugs (AEDs) and at least 1/month of seizure attack for recent 6 months, were enrolled in the study. We divided patients into two groups according to the presence of stigma. We compared demographic and clinical variables, mood, anxiety, psychiatric symptoms, and QOL between two groups.
RESULTS
Among 75 patients with DRE of partial onset, 34 patients (45%) had stigma. Risk factors associated with stigma were age, history of psychiatric disease, duration of epilepsy, and duration of AEDs intake. However, seizure frequency was not associated with the occurrence of stigma. Mood, anxiety, and psychiatric symptoms were significantly higher in patients with stigma than those without stigma. QOL was significantly lower in patients with stigma than those without stigma.
CONCLUSIONS
A longer duration of epilepsy with previous history of psychiatric diseases may be indispensable for the occurrence of stigma in patients with DRE. Early detection and appropriate treatment of psychiatric comorbidities can lessen the degree of stigma and improve QOL.