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Randi YM, Tedrus GMDAS, Nucci LB. Evaluation of social inclusion in Brazilian adult women with epilepsy: Perception of stigma and quality of life. Epilepsy Behav 2024; 156:109821. [PMID: 38704987 DOI: 10.1016/j.yebeh.2024.109821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 04/29/2024] [Accepted: 05/01/2024] [Indexed: 05/07/2024]
Abstract
Epilepsy is a chronic disease characterized by recurrent epileptic seizures that can affect the perception of stigma and compromise the quality of life of those living with it. In addition, sociodemographic factors such as employment and maintaining a job, education, and the autonomy to drive vehicles are often impaired. OBJECTIVE To assess the social inclusion of adult women with epilepsy in relation to the perception of stigma and quality of life, and the clinical aspects of the disease. METHODOLOGY Data from 70 adult Brazilian women with epilepsy regarding aspects related to their social inclusion were verified. Such data were linked to clinical aspects and scores from the questionnaires: Quality of Life in Epilepsy Inventory 31 (QOLIE-31) and the Epilepsy Stigma Scale (ESS), with a significance level of p < 0.05. RESULTS Average age of 45.5 years, 40 (57.1 %) women were divorced/single/widowed, 31 (44.3 %) women had less than 10 years of formal education, 32 (45.7 %) women had no income, and 57 (81.4 %) did not have a driver's license. The age at the time of the first seizure was 18 years, the seizures were focal in 46 (65.7 %) cases, and 26 (37.1 %) cases were seizure-free in the last year. A high number of women reported that the diagnosis of epilepsy negatively influenced aspects of autonomy such as the possession of a driver's license and going out alone. Longer duration of epilepsy was associated with lower education, not having children, and lower scores on the QOLIE-31. Higher scores on the QOLIE-31 were correlated with lower frequency of seizures and with the age at the time of the first seizure. Values in the dimension - energy and fatigue of the QOLIE-31 were significantly lower in the group with less independence compared to the other two groups with more independence, in latent class analyses (ANOVA, adjusted for age 42.1 ± 35.6 vs 57.2 ± 28.4 vs 73.9 ± 23.8, p = 0.0295). DISCUSSION Clinical aspects of epilepsy and having a partner, autonomy, and independence such as driving vehicles are factors that contribute to social inclusion and to the perception of a better quality of life for adult women with epilepsy. CONCLUSION It was observed that having a partner, autonomy, and independence such as driving vehicles are factors that contribute to social inclusion and to the perception of a better quality of life for adult women with epilepsy.
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Affiliation(s)
- Yara Maria Randi
- Postgraduate Program in Health Sciences. Pontifical Catholic University of Campinas - Campus II, Brazil.
| | | | - Luciana Bertoldi Nucci
- Postgraduate Program in Health Sciences. Pontifical Catholic University of Campinas - Campus II, Brazil.
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Ochoa-Morales A, Fresan-Orellana A, Ramírez-García MÁ, Márquez-González H, Martínez-Juárez IE, López-Uribe M, Zuniga-García C, Jara-Prado A, Luis Guerrero-Camacho J, Dávila-Ortiz de Montellano DJ. Low quality of life, increased number of anti-seizure drugs, and the lack of caregiver support are associated with internalized stigma in adult Mexican patients with epilepsy. Epilepsy Behav 2023; 144:109268. [PMID: 37245482 DOI: 10.1016/j.yebeh.2023.109268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/15/2023] [Accepted: 05/16/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND People with epilepsy (PWE) have been subject to stigma throughout history, a factor that could compromise their performance in daily life. In Mexico, little is known about the factors that may be affecting internalized stigma. OBJECTIVE To evaluate the internalized stigma in adult PWE, its relationship with the quality of life, cognitive and depressive symptomatology, and clinical-demographic characteristics. MATERIAL AND METHODS We conducted a cross-sectional study with a consecutive sampling approach in patients with epilepsy treated at the National Institute of Neurology and Neurosurgery Manuel Velasco Suárez (NINNMVS). Sociodemographic and clinical data, depressive symptomatology (Beck's depression inventory, DBI), cognition (MoCA test), quality of life (QOLIE-31 scale), and internalized stigma (King's internalized stigma scale, ISS) were evaluated. Correlations were made between the continuous variables and the ISS to select those with statistical significance and include them in a multiple linear regression model, along with the dummy variables, to explain internalized stigma. RESULTS Of 128 patients, 74 (58%) were women; 38% of the patients had more than 20 years of epilepsy evolution. In addition, 39% presented depressive symptoms, and around 60% manifested a possible cognitive impairment. The variables that showed statistical significance concerning the ISS were selected along with dummy variables for multiple linear regression analysis. The resultant model considers the QOLIE-31 total score (β = -0.489), the number of anti-seizure drugs (ASD, β = 0.253), and those patients without caregiver support (β = -0.166) with an adjusted R2 value of 0.316. CONCLUSIONS A diminishing quality of life, an increased number of ASD, and patients without caregiver support influence a slight to moderate variation of internalized stigma in Mexican PWE. Therefore, it is necessary to continue studying other possible factors that influence internalized stigma to generate effective strategies to reduce its negative effects on PWE.
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Affiliation(s)
- Adriana Ochoa-Morales
- Genetics Department. National Institute of Neurology and Neurosurgery, Manuel Velasco Suárez, Mexico City, Mexico
| | - Ana Fresan-Orellana
- Clinical Epidemiology Laboratory, Clinical Research Directorate. National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Miguel Ángel Ramírez-García
- Genetics Department. National Institute of Neurology and Neurosurgery, Manuel Velasco Suárez, Mexico City, Mexico
| | - Horacio Márquez-González
- Clinical Research Department. Children's Hospital of Mexico, Federico Gómez, Mexico City, Mexico
| | - Iris E Martínez-Juárez
- Epilepsy Clinic. National Institute of Neurology and Neurosurgery, Manuel Velasco Suárez, Mexico City, Mexico
| | - Mayra López-Uribe
- Social Work Department. National Institute of Neurology and Neurosurgery, Manuel Velasco Suárez, Mexico City, Mexico
| | - Carol Zuniga-García
- Genetics Department. National Institute of Neurology and Neurosurgery, Manuel Velasco Suárez, Mexico City, Mexico
| | - Aurelio Jara-Prado
- Genetics Department. National Institute of Neurology and Neurosurgery, Manuel Velasco Suárez, Mexico City, Mexico
| | - Jorge Luis Guerrero-Camacho
- Genetics Department. National Institute of Neurology and Neurosurgery, Manuel Velasco Suárez, Mexico City, Mexico
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Qin Y, Dai M, Chen L, Zhang T, Zhou N, Chen X. The relationship between ecological executive function and stigma among patients with epilepsy: The mediating effect of social support. Epilepsy Res 2022; 182:106919. [DOI: 10.1016/j.eplepsyres.2022.106919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 03/24/2022] [Accepted: 03/29/2022] [Indexed: 11/03/2022]
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Zhu R, Zhang L, Zheng YH, Zhang ZH, Zhang LM, Yang HL, Yue Y, Xiong X. Association between Stigma and Pain in Patients with Temporomandibular Disorders. Int J Clin Pract 2022; 2022:2803540. [PMID: 36212051 PMCID: PMC9519306 DOI: 10.1155/2022/2803540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 09/05/2022] [Accepted: 09/06/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE This study aims to explore the association between stigma and pain in patients with temporomandibular disorders (TMDs). METHODS Two hundred and twenty-five patients with TMDs were recruited, and they completed the questionnaires including the Visual Analogue Scale of Pain (VAS), Generalized Anxiety Disorder 7-Item (GAD-7), the Patient Health Questionnaire 9-item (PHQ-9), Jaw Functional Limitation Scale 8-item (JFLS-8), the Stigma Scale for Chronic Illness 8-item (SSCI-8), and other demographic and disease-related information. The total score of SSCI-8 indicated overall stigma, which could be classified into 2 subdomains, felt stigma and enacted stigma, according to their representative items, respectively. Then, the patients were divided into 2 groups in each subdomain of stigma according to their scores: stigma group (score ≥ 1) and no stigma group (score = 0). RESULTS Patients with overall stigma and enacted stigma presented significantly higher scores in VAS, GAD-7, PHQ-9, and JFLS-8 than those without overall stigma and those without enacted stigma, respectively. Significant differences between patients with and without felt stigma were only observed in GAD-7, PHQ-9, and JFLS-8. Patients with overall stigma and enacted stigma mainly suffered from pain-related TMDs (PTs) and combined TMDs (CTs). Overall stigma and enacted stigma rather than felt stigma were significantly associated with both PTs and CTs. Stigma, including overall stigma, enacted stigma, and felt stigma, was more associated with anxiety and depression and less related to jaw functional limitation of the patients with TMDs. CONCLUSION Stigma, specifically enacted stigma, was correlated to pain in patients with TMDs. Stigma was more related to psychological problems than jaw functional limitation.
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Affiliation(s)
- Rui Zhu
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Li Zhang
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yun-Hao Zheng
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Zi-Han Zhang
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Li-Ming Zhang
- Rehabilitation Medicine Center, Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hao-Lun Yang
- Rehabilitation Medicine Center, Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yuan Yue
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Xin Xiong
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
- Department of Temporomandibular Joint, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
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Rivera Bonet CN, Hwang G, Hermann B, Struck AF, J Cook C, A Nair V, Mathis J, Allen L, Almane DN, Arkush K, Birn R, Conant LL, DeYoe EA, Felton E, Maganti R, Nencka A, Raghavan M, Shah U, Sosa VN, Ustine C, Prabhakaran V, Binder JR, Meyerand ME. Neuroticism in temporal lobe epilepsy is associated with altered limbic-frontal lobe resting-state functional connectivity. Epilepsy Behav 2020; 110:107172. [PMID: 32554180 PMCID: PMC7483612 DOI: 10.1016/j.yebeh.2020.107172] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 05/11/2020] [Accepted: 05/11/2020] [Indexed: 11/18/2022]
Abstract
Neuroticism, a core personality trait characterized by a tendency towards experiencing negative affect, has been reported to be higher in people with temporal lobe epilepsy (TLE) compared with healthy individuals. Neuroticism is a known predictor of depression and anxiety, which also occur more frequently in people with TLE. The purpose of this study was to identify abnormalities in whole-brain resting-state functional connectivity in relation to neuroticism in people with TLE and to determine the degree of unique versus shared patterns of abnormal connectivity in relation to elevated symptoms of depression and anxiety. Ninety-three individuals with TLE (55 females) and 40 healthy controls (18 females) from the Epilepsy Connectome Project (ECP) completed measures of neuroticism, depression, and anxiety, which were all significantly higher in people with TLE compared with controls. Resting-state functional connectivity was compared between controls and groups with TLE with high and low neuroticism using analysis of variance (ANOVA) and t-test. In secondary analyses, the same analytics were performed using measures of depression and anxiety and the unique variance in resting-state connectivity associated with neuroticism independent of symptoms of depression and anxiety identified. Increased neuroticism was significantly associated with hyposynchrony between the right hippocampus and Brodmann area (BA) 9 (region of prefrontal cortex (PFC)) (p < 0.005), representing a unique relationship independent of symptoms of depression and anxiety. Hyposynchrony of connection between the right hippocampus and BA47 (anterior frontal operculum) was associated with high neuroticism and with higher depression and anxiety scores (p < 0.05), making it a shared abnormal connection for the three measures. In conclusion, increased neuroticism exhibits both unique and shared patterns of abnormal functional connectivity with depression and anxiety symptoms between regions of the mesial temporal and frontal lobe.
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Affiliation(s)
| | - Gyujoon Hwang
- Department of Medical Physics, University of Wisconsin-Madison, United States of America
| | - Bruce Hermann
- Department of Neurology, University of Wisconsin-Madison, United States of America
| | - Aaron F Struck
- Department of Neurology, University of Wisconsin-Madison, United States of America
| | - Cole J Cook
- Department of Medical Physics, University of Wisconsin-Madison, United States of America
| | - Veena A Nair
- Department of Radiology, University of Wisconsin-Madison, United States of America
| | - Jedidiah Mathis
- Department of Radiology Froedtert & Medical College of Wisconsin, United States of America
| | - Linda Allen
- Department of Neurology, Medical College of Wisconsin, United States of America
| | - Dace N Almane
- Department of Neurology, University of Wisconsin-Madison, United States of America
| | - Karina Arkush
- Neuroscience Innovation Institute, Aurora St. Luke's Medical Center, United States of America
| | - Rasmus Birn
- Neuroscience Training Program, University of Wisconsin-Madison, United States of America; Department of Medical Physics, University of Wisconsin-Madison, United States of America; Department of Psychiatry, University of Wisconsin-Madison, United States of America
| | - Lisa L Conant
- Department of Neurology, Medical College of Wisconsin, United States of America
| | - Edgar A DeYoe
- Department of Radiology Froedtert & Medical College of Wisconsin, United States of America; Department of Biophysics, Medical College of Wisconsin, United States of America
| | - Elizabeth Felton
- Department of Neurology, University of Wisconsin-Madison, United States of America
| | - Rama Maganti
- Department of Neurology, University of Wisconsin-Madison, United States of America
| | - Andrew Nencka
- Department of Radiology Froedtert & Medical College of Wisconsin, United States of America
| | - Manoj Raghavan
- Department of Neurology, Medical College of Wisconsin, United States of America
| | - Umang Shah
- Neuroscience Innovation Institute, Aurora St. Luke's Medical Center, United States of America
| | - Veronica N Sosa
- Neuroscience Innovation Institute, Aurora St. Luke's Medical Center, United States of America
| | - Candida Ustine
- Department of Neurology, Medical College of Wisconsin, United States of America
| | - Vivek Prabhakaran
- Neuroscience Training Program, University of Wisconsin-Madison, United States of America; Department of Neurology, University of Wisconsin-Madison, United States of America; Department of Radiology, University of Wisconsin-Madison, United States of America
| | - Jeffrey R Binder
- Department of Neurology, Medical College of Wisconsin, United States of America; Department of Biophysics, Medical College of Wisconsin, United States of America
| | - Mary E Meyerand
- Neuroscience Training Program, University of Wisconsin-Madison, United States of America; Department of Medical Physics, University of Wisconsin-Madison, United States of America; Department of Radiology, University of Wisconsin-Madison, United States of America
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