Associations of self-esteem in people with epilepsy

This systematic review aimed 1) to identify and examine research on factors associated with self-esteem in people with epilepsy (PWE), 2) to provide a quality assessment of these studies, and 3) to make recommendations for clinical practice and future research.

Systematic searches were conducted on three databases: Scopus, PsycINFO, and Medline, in January 2023. Additional publications were sought by backwards and forward citation searches. Studies meeting inclusion criteria were quality assessed before data extraction.

Twenty-six articles were included, with a total sample size of N = 3,405 across studies. Most studies were cross-sectional and of moderate quality. In PWE, factors associated with self-esteem fell into four categories: seizure-related, psychological, social, and 'quality and satisfaction of life' outcomes. Negative self-esteem correlates in PWE included stigma, anxiety, and depression; positive correlates of self-esteem were knowledge about epilepsy, life satisfaction, quality of life, self-efficacy, helpful coping styles, social support, and community integration. Studies examining the association between seizure frequency and self-esteem yielded mixed findings.

The review's results were consistent with previous studies on self-esteem in other healthy and clinical populations. Findings in PWE suggest that healthcare providers should assess and provide holistic interventions to increase self-esteem in PWE, as it relates to various positive life outcomes. In addition, societal-level interventions should reduce the impact of stigma on the self-esteem of PWE.