A review of research on psychosocial adjustment to impairment among persons with epilepsy

Psychosocial Adaptation to Epilepsy: The Role of Coping Strategies

“…Even research findings on nonpathological factors still emphasize the negative correlates of life with epilepsy, including poor quality of life and decreased psychosocial well-being (43,44). Among the various interictal epileptic behavioral, emotional, and personality correlates (often seen also as psychosocial outcomes to the process of adaptation to epilepsy) are those of psychotic symptoms, aggressive behaviors, violence, suicide, sexual dysfunction, and a wide range of affective and cognitive disorders, such as depression, anxiety, and decreased self-esteem (39,43,(45)(46)(47).…”

“…The reasons underlying these putative findings can be traced to factors such as: (a) side effects of anticonvulsant medication and other iatrogenic factors; (b) neurological (i.e., central nervous system) factors that include type and cause of seizures, frequency and level of severity of seizures, and age of onset and duration of condition; and (c) psychosocial factors manifested by degree of stress experienced, felt or perceived stigma and encountered social discrimination, perceived controllability of seizures, associated anxiety, and concerns about the condition and the future (41,42,45,48,49).…”

“…Its numerous discrediting attributes include these of criminal tendencies, sexual deviance, mental incompetence, and moral decadence (41,45). Consequences of these discriminating perceptions typically result in (a) denial of common benefits (e.g., life and health insurance, driver's license); (b) restrictions on ordinary life activities (e.g., exclusion from school, adoption of eugenic marriage laws); (c) limitations on life experiences that result in independence (e.g., employment discrimination, housing restrictions); and (d) internalized feelings of societal rejection and devaluation leading to feelings of social isolation and withdrawal, depression, frustration, hostility, dependency, shame, and guilt (41,42,45,61,62). Hermann and Whitman (63), in their study of 102 adults with epilepsy, found a statistically significant correlation between perceived stigma and depression.…”

“…Life stressors triggered by epilepsy include a wide range of negatively valenced events such as the need to follow rigid medical regimen, increased memory loss, inability to obtain a driver's license, limitations imposed on various daily activities, frustration with medication's inability to "cure" seizures and their pernicious side effects, cost of medication, difficulty in obtaining health and life insurance, fear of injury to oneself, overprotectiveness by family and friends, dependency on others, rejection by society, restrictions imposed on the use of alcohol, fear about one's own children who may become seizure-prone, and fear about sexual activity (45,51,(65)(66)(67). Hermann et al (64), in a study of 102 patients with epilepsy, reported a significant positive relationship between increased number of stressful life events during the past year and increased psychopathology as measured by the GHQ-30.…”

Questionário de qualidade de vida na epilepsia: resultados preliminares

“…Uma revisão crítica foi feita recentemente por Sander e ODonoghue 10 e Leidy et al 11 . O primeiro estudo sistemático na área foi desenvolvido por Dodrill et al 12 que, apesar de ser considerado um passo na quantificação de auto-relatos, acabou não preenchendo muitos critérios de avaliação de QV relacionados à saúde abordados pelas pesquisas sociais nas últimas décadas 13 . 20 , como medida da efetividade da lobectomia anterotemporal, representou uma tentativa para produzir uma avaliação de QV breve e adequada.…”