Exploring Korean adolescents' perceptions of epilepsy-related stigma in the general population: Changes over the past decade and influential factors

We investigated Korean adolescents' familiarity with, knowledge of, and stigmatizing attitudes toward epilepsy, and the factors associated with stigma, to inform stigma-reduction measures.

We analyzed responses from 4244 adolescents to a nationwide 37-item questionnaire on demographics, familiarity, knowledge, and stigma. Factors associated with stigma were examined by hierarchical multiple regression with the knowledge score entered last. Findings were compared with those of a 2010 survey using the same questionnaire with minor modifications.

Familiarity has declined since 2010: fewer participants had heard or read about epilepsy (29.9% vs. 45.1%), knew people with epilepsy (PWE; 2.8% vs. 8.1%), or had attended a lecture (0.8% vs. 4.1%). Knowledge improved for most items, but the same misconceptions persisted. Stigma-related responses generally improved, yet acceptance in principle did not extend to personal willingness: 60.8% reported that they could get along with a friend with epilepsy, whereas only 25.3% would date PWE. The knowledge score showed the strongest association with lower stigma (B = -0.259; 95% CI, -0.277 to -0.241; p < 0.001). Knowing PWE remained associated with lower stigma after adjustment for knowledge (p = 0.005), whereas coefficients for the other significant variables were attenuated by 40-70%. Actual lecture attendance was not associated with stigma.

Knowledge remains the dominant correlate of lower stigma, yet better knowledge alone has not translated into correspondingly less stigmatizing attitudes. Approaches that produce a genuine reduction in stigma, rather than improvements in stated attitudes alone, are therefore needed.