A biopsychosocial model of psychological distress in epilepsy

Abstract

This study investigated the relative strength and importance of selected biological and psychosocial factors in predicting psychological distress in adolescents with idiopathic epilepsy. A biopsychosocial model of psychological distress in epilepsy provided the framework for this investigation. The model was developed based on the results of pilot research and theoretical work on stigma. Three biological variables (seizure type, seizure frequency, and age at onset of epilepsy) and three psychosocial variables (perceived stigma, management of disclosure of epilepsy, and self-esteem) were studied to determine their effect on psychological symptom status.;This study used a cross-sectional, within-group design. Sixty-four adolescents with idiopathic epilepsy were recruited from outpatient medical clinics and private physicians offices. Eligible subjects were interviewed about school and demographic characteristics, and completed self-administered questionnaires for psychological data.;Data were analyzed using hierarchical multiple regressions and path analyses. Self-esteem was dropped as an independent variable but used in the remainder of the analysis as another dependent variable. Management of disclosure was excluded from the multivariate analyses.;Results showed that psychological symptoms were more likely to be reported by females, by subjects with either focal or tonic-clonic seizures, by subjects who had frequent seizures, or by those who believed that they were stigmatized by their epilepsy. From the path analysis, seizure frequency was found to be the most important predictor overall.;Results also showed that low self-esteem was more likely to be reported by females, by subjects with either focal or tonic-clonic seizures, by subjects who had frequent seizures, by subjects with early childhood onset of epilepsy, or by those who believed that they were stigmatized by their epilepsy. Focal seizures was found to be the most important predictor overall.;Generally, biological factors were the strongest and most important predictors of psychological symptom status and self-esteem. The findings also identified perceived stigma as a potential risk factor for the development of psychopathology in adolescents with idiopathic epilepsy.;The data supported two components (paths) of the original model, and a revised model of psychological distress in epilepsy is proposed for further research.