Association between Self-Stigma and psychological distress in epilepsy.

INTRODUCTION: Self-stigma is increasingly recognised as an important psychosocial burden among people with epilepsy (PWE), particularly among those experiencing depressive and anxiety symptoms. This study examined the association between self-stigma, psychological symptoms, self-esteem, work motivation, and quality of life in PWE. METHODS: In this cross-sectional study, adults with epilepsy were assessed using the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), Generalised Anxiety Disorder-7 (GAD-7), Epilepsy Self-Stigma Scale (ESSS), Rosenberg Self-Esteem Scale (RSES), Work Extrinsic and Intrinsic Motivation Scale (WEIMS), and Quality of Life in Epilepsy Inventory-31 (QOLIE-31). Participants screening positive for depression and/or severe anxiety symptoms were offered psychiatric referral. Group comparisons and Pearson correlation analyses were performed. RESULTS: Of 207 patients, 34 (16.4%) screened positive for depression and/or severe anxiety symptoms. Compared with those screened negative, they had poorer seizure control (76.5% vs. 56.1%,p = 0.027), higher self-stigma (22.24 ± 4.09 vs. 18.49 ± 4.08,p < 0.001), lower self-esteem (p = 0.036), reduced work self-determination (WSDI 1.07 ± 6.62 vs. 5.21 ± 6.33, p < 0.001), and poorer quality of life (p < 0.05). Higher self-stigma was significantly correlated with greater depression and anxiety scores (NDDI-E: r = 0.401; GAD-7: r = 0.462, both p < 0.01), as well as lower self-esteem (r = - 0.140, p < 0.05), reduced work self-determination (r = - 0.209, p < 0.01), and poorer quality of life (r = - 0.436, p < 0.01). CONCLUSION: People with epilepsy who screened positive for depressive and/or severe anxiety symptoms had higher self-stigma, lower self-esteem, lower work self-determination, and poorer quality of life.