Whether the Presence of Depressions Increases Stigmatization of People with Epilepsy?

Epilepsy is a disease that affects more than 50 million people worldwide. This most common chronic neurological disorder, which actually represents impairment of some brain structures, makes the patients suffering from epilepsy victims of environmental stigma, which, due to ignorance, is considered them to be mentally ill.

The aim of the study was to examine the demographic data of epilepsy patients, disease duration, frequency of seizures and type of therapy (mono/polytherapy), determine the existence of depressive symptomatology in patients with epilepsy and to examine predictive gender significance, degree of education, employment status, type of epileptic seizure on the presence of stigma.

The sample consisted of 100 respondents, both sexes, treated in the Epilepsy Outpatient Clinic of the Clinic for Neurology of the Clinical Center of the University of Sarajevo, selected randomly. All respondents fulfilled the Mini Mental Status Test. Patients who met the required score (27 and more of a total of 30) performed a test to evaluate the possible presence of depressive affective disorder with Back's Depression Scale. They also responded to the questionnaire of the revised version of Epilepsy Stigma Scale.

The mean age of the respondents was 37.46±11.9 years. Men are on average older 40.84±11.9 years, than women 34.69±11.2 in the tested sample, and the difference shown is statistically significant, p=0.009. The difference in the frequency of respondents by status of employment is statistically significant, χc²=50.4; p=0.0001. According to Beck's Depression Scale, a total of 15 respondents were without a stigma, a total of 51 respondents felt mild stigma, and 34 respondents felt high level of stigma, 18 of which (52.9%) with score ≤9, 2 (5.9%) score 10-15, 4 (11.8%) had a score of 16-19, 4 (11.8%) score of 20-29, while 6 (17.6%) had a score of ≥30. The degree of depression and the degree of stigma are in correlation, p=0.011. The time without epileptic seizures was approximately 6 (3-8) months for respondents without stigma, in respondents with mild stigma 4 (3-6) months and respondents with high stigma 6 (4-9) months. The mean time without epileptic seizures is statistically significantly different in relation to the degree of stigma, p=0.026.

The results of this study showed that poor control of epileptic seizures and the presence of depression had a significant predictive value for the development of the stigma. Therefore, in addition to establishing good control over epileptic manifestations, it is extremely important to pay attention to psychological changes, to raise awareness in the community, to continuously carry out education, in order to have the best outcomes in treatment of a patient with epilepsy.