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Biresaw MS, Vitrai J, Halász P, Correa V, Szűcs A. Changes in public attitude toward epilepsy in Hungary since 1994. A multicriteria weighting analysis. Epilepsia Open 2024; 9:1042-1050. [PMID: 38546973 PMCID: PMC11145619 DOI: 10.1002/epi4.12935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/13/2024] [Accepted: 03/19/2024] [Indexed: 06/04/2024] Open
Abstract
OBJECTIVE To assess the adult Hungarian population's knowledge about and attitude toward epilepsy and compare the present findings with previous ones in 1994 and 2000. METHODS We performed a cross-sectional survey of the Hungarian adult population from 28th February to 8th March 2023. A non-probability quota sampling with a random walk method was used. We applied the computer-assisted personal interviewing (CAPI) method and used a multicriteria weighting procedure to correct for bias along the main sociodemographic variables. To detect changes over time, we used chi-squared tests, and to analyze the effect of sociodemographic characteristics, we applied multivariate logistic regression. RESULTS One thousand participants (53.1% women, mean age 48.1 ± 16.75 years) representing Hungary's population were interviewed yielding a response rate of 80.3%. 26.3% knew someone with epilepsy (55.9% in 1994 and 51.9% in 2000), and 30.8% saw an epileptic seizure (58% in 1994 and 55.3% in 2000). Compared to the young, fewer adults and elderly people knew someone with epilepsy or had seen a seizure. Like in 1994 and 2000, 16.6% reported objection to their children's interaction with people with epilepsy; however, in the present study, significantly fewer people opposed their children marrying or working together with epileptic people, indicating a change in attitude (p < 0.0001). Rural residents had less objection to their children's interaction with people with epilepsy (p < 0.05). People with secondary education objected significantly more often than those with primary education to their children's interaction (p = 0.037), marriage to people with epilepsy (p = 0.043), or their having equal employment (p = 0.008). Higher education people were as "permissive" as those with primary education. SIGNIFICANCE Certain parameters of familiarity and attitude markers of the Hungarian population toward epilepsy have improved. These tendencies are promising, but work is still needed; our results will hopefully evoke educational programs and campaigns against negative attitudes. PLAIN LANGUAGE SUMMARY The knowledge of the Hungarian population about epilepsy and their attitude toward people with epilepsy has been improved since 1994. People from rural areas have shown more acceptance for people with epilepsy. Those people who completed secondary education were significantly more prone to stigmatization than those with primary education.
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Affiliation(s)
- Mengesha Srahbzu Biresaw
- Department of Behavioral SciencesDoctoral School of Mental Health SciencesSemmelweis UniversityBudapestHungary
| | - József Vitrai
- Department of Preventive Health Sciences, Faculty of Health and Sport SciencesSzéchenyi István UniversityGyőrHungary
| | - Péter Halász
- Department of Preventive Health SciencesSzentágothai Doctoral SchoolSemmelweis UniversityBudapestHungary
| | - Vivian Correa
- Department of Behavioral SciencesDoctoral School of Mental Health SciencesSemmelweis UniversityBudapestHungary
| | - Anna Szűcs
- Department of Behavioral SciencesSemmelweis UniversityBudapestHungary
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Sillanpää ML, Camfield P, Löyttyniemi E. The changing incidence of childhood epilepsy in Finland. Seizure 2024; 117:20-27. [PMID: 38308905 DOI: 10.1016/j.seizure.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 02/05/2024] Open
Abstract
INTRODUCTION to investigate the childhood epilepsy incidence, population trends, associated factors, and validate the national population registers. METHODS a comprehensive comparative analysis of childhood epilepsy in the population during two distinct time intervals using medical records, appropriate national medical and population registers, and two random samples for control. RESULTS In 1961-1964, the average incidence of epilepsy was 38/100,000 and during 1991-2000 65.9 (95 % CI 59.6 to 72.2) and 65.6/100,000 person-years after adjustment for the European Standard Population. This increase was significant (p<0.0001) as was a decline (p<0.003) from 1991 to 1995 to 1996-2000. The decline in incidence for girls occurred at a younger age compared to boys. Epilepsy cases associated with prenatal and perinatal factors were 50 % lower in 1991-2000 than in 1961-1964, especially related to asphyxia, infections, pre-eclampsia, and imminent abortion. The national Register for Healthcare independently identified 94.5 % of relevant cases (University Hospital alone 81.2 %, and Drug Register alone 74.3 %). DISCUSSION Over the past five decades, the incidence rate of childhood epilepsy has exhibited a dynamic pattern, with a notable increase until the 1990's, followed by a stabilization at an incidence rate of approximately 60-70 per 100,000 person-years. Our findings, in line with other recent Finnish research, support a significant decrease in incidence since the mid-1990's. The underlying reasons for the increase and decrease remain unclear. Finnish national registers for epilepsy have established themselves as highly dependable resources for conducting epidemiological research. CONCLUSION Childhood epilepsy incidence in Finland is similar to other industrialized countries, but there are signs of a declining trend emerging.
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Affiliation(s)
- Matti L Sillanpää
- Departments of Child Neurology and Family Practice, University of Turku and Turku University Hospital, Turku, Finland.
| | - Peter Camfield
- Department of Pediatrics, Dalhousie University and the IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Eliisa Löyttyniemi
- Department of Biostatistics, University of Turku and Turku University Hospital, Turku, Finland
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Tokuç FEU, Genç F, Göksu EÖ, Erdal A, Gömceli YB. Marriage and childbearing in patients with epilepsy in Turkey. Front Neurol 2024; 15:1304076. [PMID: 38585357 PMCID: PMC10996395 DOI: 10.3389/fneur.2024.1304076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 02/23/2024] [Indexed: 04/09/2024] Open
Abstract
Introduction For epilepsy, a common neurological disorder, brings psychosocial challenges like stigma, employment difficulties, and barriers to marriage and childbearing. Stigma often stems from misconceptions and societal beliefs, particularly in less developed regions like Turkey. However, research on the marital and childbearing experiences of epilepsy patients in such settings is limited. We aimed to research the marriage and childbearing behaviors of men and women with epilepsy. Methods We conducted a cross-sectional study involving 215 adult epilepsy patients at Antalya Training and Research Hospital between 2019 and 2022. Patients were asked questions about marriage and having children on prepared questionnaires. Result The gender distribution of the 215 patients included in the study was revealed to be 62.3% (134) females and 37.7% (81) males. 71.6% of patients were married, and 12.7% had no children. 33.3% of these patients stated that they did not desire children because of the disease. A statistically significant correlation was observed between the duration of the disease and being unmarried. A significant correlation was observed between age at disease onset and number of children. Conclusion Our study revealed the effects of individuals with epilepsy on marriage and childbearing, and as we know, it is the first study conducted in Turkey on childbearing attitudes in individuals with epilepsy. Despite medical and social developments, epilepsy is still one of the most stigmatized diseases, and the disease has considerable negative effects on marriage and fertility. Our study supported the findings of a small number of previous similar studies on this subject and additionally showed that the likelihood of having children decreased in patients using multiple ASM, and on the other hand, it showed that marriage positively affected patients in terms of social support.
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Affiliation(s)
| | - Fatma Genç
- Department of Neurology, Antalya Training and Research Hospital, Antalya, Türkiye
| | - Eylem Özaydın Göksu
- Department of Neurology, Antalya Training and Research Hospital, Antalya, Türkiye
| | - Abidin Erdal
- Department of Neurology, Health Ministry of Türkiye Republic, Ankara Bilkent City Hospital, Ankara, Türkiye
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Kuramochi I, Iwayama T, Brandt C, Yoshimasu H, Bien CG, Hagemann A. Assessment of self-stigma in epilepsy: Validation of the German version Epilepsy Self-Stigma Scale (ESSS-G). Epilepsia Open 2023; 8:946-958. [PMID: 37254471 PMCID: PMC10472374 DOI: 10.1002/epi4.12765] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 05/23/2023] [Indexed: 06/01/2023] Open
Abstract
OBJECTIVE Self-stigma is the internalization of unfavorable public perceptions, which people with epilepsy (PWE) frequently experience. PWE with strong self-stigma have low self-esteem and are less likely to engage in treatment behavior. The Epilepsy Self-Stigma Scale (ESSS) has been developed and validated in Japan. We translated the ESSS into German for this study to examine its reliability and validity. METHODS We created the German version of ESSS (ESSS-G) based on the original Japanese version. From May to October 2022, we recruited out- and inpatients from Bethel Epilepsy Centre, University Hospital for Epileptology, for psychometric evaluation. Inclusion criteria were an age of ≥18 years, sufficient reading and speaking skills in German, and the ability to comprehend the German questionnaires. Participants also completed the Rosenberg Self-Esteem Scale (RSES), Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), Generalized Anxiety Disorder 7 (GAD-7), Epilepsy Knowledge Scale, and items on "overall quality of life (QOL)" and "overall health" (items from QOLIE-31). RESULTS One hundred twenty-eight of 146 patients asked to participate granted informed consent and completed the study questionnaire (87.7% response rate). 115 cases were analyzed since 13 did not match the inclusion criteria. The analysis revealed a single factor explaining 49.2% of the total variance. All factor loadings were >0.40, and the reliability was high (Cronbach's α = 0.80). Higher ESSS total scores were associated with higher anxiety (GAD-7, r = 0.54, P < 0.001) and depression (NDDI-E, r = 0.45, P < 0.001), lower self-esteem (RSES, r = -0.41, P < 0.001), overall QOL (r = -0.40, P < 0.001), and overall health (r = -0.35, P < 0.001), but not with knowledge about epilepsy (r = 0.03, P = 0.770). In Germany, females, younger individuals, patients with earlier seizure onset, and those with generalized epilepsy had significantly higher self-stigma. SIGNIFICANCE The German version of the ESSS proved reliable and valid. It allows to evaluate the efficacy of treatment strategies in lowering self-stigma and conducting intercultural comparisons of epilepsy self-stigma.
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Affiliation(s)
- Izumi Kuramochi
- Department of Epileptology (Krankenhaus Mara)Bielefeld University, Medical SchoolBielefeldGermany
- Department of Psychiatry, Saitama Medical CenterSaitama Medical UniversitySaitamaJapan
| | - Takayuki Iwayama
- Department of Psychiatry, Saitama Medical CenterSaitama Medical UniversitySaitamaJapan
- Department of PsychologyShowa Women's UniversityTokyoJapan
| | - Christian Brandt
- Department of Epileptology (Krankenhaus Mara)Bielefeld University, Medical SchoolBielefeldGermany
- Society for Epilepsy ResearchBielefeldGermany
| | - Haruo Yoshimasu
- Department of Psychiatry, Saitama Medical CenterSaitama Medical UniversitySaitamaJapan
| | - Christian G. Bien
- Department of Epileptology (Krankenhaus Mara)Bielefeld University, Medical SchoolBielefeldGermany
- Society for Epilepsy ResearchBielefeldGermany
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Siebenbrodt K, Willems LM, von Podewils F, Mross PM, Strüber M, Langenbruch L, Bierhansl L, Gorny I, Schulz J, Gaida B, Conradi N, Süß A, Rosenow F, Strzelczyk A. Determinants of quality of life in adults with epilepsy: a multicenter, cross-sectional study from Germany. Neurol Res Pract 2023; 5:41. [PMID: 37533112 PMCID: PMC10398956 DOI: 10.1186/s42466-023-00265-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 07/04/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND Assessment of quality of life (QoL) has become an important indicator for chronic neurological diseases. While these conditions often limit personal independence and autonomy, they are also associated with treatment-related problems and reduced life expectancy. Epilepsy has a tremendous impact on the QoL of patients and their families, which is often underestimated by practitioners. The aim of this work was to identify relevant factors affecting QoL in adults with epilepsy. METHODS This cross-sectional, multicenter study was conducted at four specialized epilepsy centers in Germany. Patients diagnosed with epilepsy completed a standardized questionnaire focusing on QoL and aspects of healthcare in epilepsy. Univariate regression analyses and pairwise comparisons were performed to identify variables of decreased QoL represented by the overall Quality of Life in Epilepsy Inventory (QOLIE-31) score. The variables were then considered in a multivariate regression analysis after multicollinearity analysis. RESULTS Complete datasets for the QOLIE-31 were available for 476 patients (279 [58.6%] female, 197 [41.4%] male, mean age 40.3 years [range 18-83 years]). Multivariate regression analysis revealed significant associations between low QoL and a high score on the Liverpool Adverse Events Profile (LAEP; beta=-0.28, p < 0.001), Hospital Anxiety and Depression Scale - depression subscale (HADS-D; beta=-0.27, p < 0.001), Neurological Disorders Depression Inventory in Epilepsy (NDDI-E; beta=-0.19, p < 0.001), revised Epilepsy Stigma Scale (beta=-0.09, p = 0.027), or Seizure Worry Scale (beta=-0.18, p < 0.001) and high seizure frequency (beta = 0.14, p < 0.001). CONCLUSION Epilepsy patients had reduced QoL, with a variety of associated factors. In addition to disease severity, as measured by seizure frequency, the patient's tolerability of anti-seizure medications and the presence of depression, stigma, and worry about new seizures were strongly associated with poor QoL. Diagnosed comorbid depression was underrepresented in the cohort; therefore, therapeutic decisions should always consider individual psychobehavioral and disease-specific aspects. Signs of drug-related adverse events, depression, fear, or stigmatization should be actively sought to ensure that patients receive personalized and optimized treatment. TRIAL REGISTRATION German Clinical Trials Register (DRKS00022024; Universal Trial Number: U1111-1252-5331).
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Affiliation(s)
- Kai Siebenbrodt
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Goethe-University and University Hospital Frankfurt, Frankfurt am Main, Germany.
- LOEWE Center for Personalized Translational Epilepsy Research (CEPTeR), Goethe-University Frankfurt, Frankfurt am Main, Germany.
| | - Laurent M Willems
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Goethe-University and University Hospital Frankfurt, Frankfurt am Main, Germany
- LOEWE Center for Personalized Translational Epilepsy Research (CEPTeR), Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Felix von Podewils
- Department of Neurology, Epilepsy Center, University Hospital Greifswald, Greifswald, Germany
| | - Peter Michael Mross
- Epilepsy Center Hessen and Department of Neurology, Philipps-University Marburg, Marburg, Germany
- Institute for Artificial Intelligence in Medicine, Philipps-University Marburg, Marburg, Germany
| | - Michael Strüber
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Goethe-University and University Hospital Frankfurt, Frankfurt am Main, Germany
- LOEWE Center for Personalized Translational Epilepsy Research (CEPTeR), Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Lisa Langenbruch
- Institute for Artificial Intelligence in Medicine, Philipps-University Marburg, Marburg, Germany
| | - Laura Bierhansl
- Epilepsy Center Münster-Osnabrück, Department of Neurology with Institute of Translational Neurology, Westfälische Wilhelms-University, Münster, Germany
| | - Iris Gorny
- Epilepsy Center Hessen and Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - Juliane Schulz
- Department of Neurology, Epilepsy Center, University Hospital Greifswald, Greifswald, Germany
| | - Bernadette Gaida
- Department of Neurology, Epilepsy Center, University Hospital Greifswald, Greifswald, Germany
| | - Nadine Conradi
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Goethe-University and University Hospital Frankfurt, Frankfurt am Main, Germany
- LOEWE Center for Personalized Translational Epilepsy Research (CEPTeR), Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Annika Süß
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Goethe-University and University Hospital Frankfurt, Frankfurt am Main, Germany
- LOEWE Center for Personalized Translational Epilepsy Research (CEPTeR), Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Felix Rosenow
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Goethe-University and University Hospital Frankfurt, Frankfurt am Main, Germany
- LOEWE Center for Personalized Translational Epilepsy Research (CEPTeR), Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Adam Strzelczyk
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Goethe-University and University Hospital Frankfurt, Frankfurt am Main, Germany
- LOEWE Center for Personalized Translational Epilepsy Research (CEPTeR), Goethe-University Frankfurt, Frankfurt am Main, Germany
- Epilepsy Center Hessen and Department of Neurology, Philipps-University Marburg, Marburg, Germany
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Sarkis RA, Gifford A, Chemali Z. On epilepsy and education: Global perspectives and knowledge of epilepsy. Epilepsy Behav 2023; 144:109265. [PMID: 37244220 DOI: 10.1016/j.yebeh.2023.109265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 05/11/2023] [Accepted: 05/12/2023] [Indexed: 05/29/2023]
Affiliation(s)
- Rani A Sarkis
- Department of Neurology, Brigham and Women's Hospital, Boston, MA 02115, United States; Harvard Medical School, Boston, MA 02115, United States.
| | - Abbott Gifford
- Boston Healthcare for the Homeless Program, Boston, MA 02114, United States
| | - Zeina Chemali
- Harvard Medical School, Boston, MA 02115, United States; Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, United States; Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, United States
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