Cargando…

Perceived epilepsy-related stigma is linked to the socioeconomic status of the residence

PURPOSE: Epilepsy is one of the most common neurological disorders with high costs for the healthcare systems and great suffering for patients. Beyond seizures, psychosocial comorbidities can have detrimental effects on the well-being of people with epilepsy. One source of social stress and reduced...

Descripción completa

Detalles Bibliográficos
Autores principales: Hohmann, Louisa, Berger, Justus, Kastell, Shirley-Uloma, Holtkamp, Martin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9459334/
https://www.ncbi.nlm.nih.gov/pubmed/36091545
http://dx.doi.org/10.3389/fpubh.2022.952585
_version_ 1784786488362270720
author Hohmann, Louisa
Berger, Justus
Kastell, Shirley-Uloma
Holtkamp, Martin
author_facet Hohmann, Louisa
Berger, Justus
Kastell, Shirley-Uloma
Holtkamp, Martin
author_sort Hohmann, Louisa
collection PubMed
description PURPOSE: Epilepsy is one of the most common neurological disorders with high costs for the healthcare systems and great suffering for patients. Beyond seizures, psychosocial comorbidities can have detrimental effects on the well-being of people with epilepsy. One source of social stress and reduced quality of life is epilepsy-related stigma that often occurs, e.g., due to public misconceptions or myths. Stigma has individual biological, psychological and social correlates. Moreover, environmental factors like living in remote areas are associated with stigma. However, little is known about the link between the social structure of the residence and stigma in epilepsy. Thus, we investigated the association between the structural socioeconomic status (SES) and perceived stigma in an urban epilepsy population. METHODS: This prospective, cross-sectional study examined 226 adult in-patients with epilepsy from Berlin. Multiple regression analyses were performed to check the relationship between structural SES and stigma controlling for individual-level demographic, clinical, psychological and social factors. Continuous social indices (SI) of the districts and neighborhoods (“SI district” and “SI neighborhood”) of Berlin were used to measure different levels of structural SES. Non-linear relationships are tested by grouping the SI in quartiles. RESULTS: Both indicators of structural SES were independently linked to stigma (p = 0.002). For “SI district”, we identified a non-linear relationship with patients from the most deprived quartile feeling less stigmatized compared to those in the second (p < 0.001) or least deprived quartile (p = 0.009). Furthermore, more restrictions of daily life (p < 0.001), unfavorable income (p = 0.009) and seizure freedom in the past 6 months (p = 0.05) were related to increased stigma. A lower “SI neighborhood” was associated with higher stigma (p = 0.002). CONCLUSION: Strategies to reduce epilepsy-related stigma need to consider the sociostructural living environment on different regional levels. Unfavorable relations with the immediate living environment may be directly targeted in patient-centered interventions. Non-linear associations with the structural SES of broader regional levels should be considered in public education programs. Further research is needed to examine possible underlying mechanisms and gain insight into the generalizability of our findings to other populations.
format Online
Article
Text
id pubmed-9459334
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-94593342022-09-10 Perceived epilepsy-related stigma is linked to the socioeconomic status of the residence Hohmann, Louisa Berger, Justus Kastell, Shirley-Uloma Holtkamp, Martin Front Public Health Public Health PURPOSE: Epilepsy is one of the most common neurological disorders with high costs for the healthcare systems and great suffering for patients. Beyond seizures, psychosocial comorbidities can have detrimental effects on the well-being of people with epilepsy. One source of social stress and reduced quality of life is epilepsy-related stigma that often occurs, e.g., due to public misconceptions or myths. Stigma has individual biological, psychological and social correlates. Moreover, environmental factors like living in remote areas are associated with stigma. However, little is known about the link between the social structure of the residence and stigma in epilepsy. Thus, we investigated the association between the structural socioeconomic status (SES) and perceived stigma in an urban epilepsy population. METHODS: This prospective, cross-sectional study examined 226 adult in-patients with epilepsy from Berlin. Multiple regression analyses were performed to check the relationship between structural SES and stigma controlling for individual-level demographic, clinical, psychological and social factors. Continuous social indices (SI) of the districts and neighborhoods (“SI district” and “SI neighborhood”) of Berlin were used to measure different levels of structural SES. Non-linear relationships are tested by grouping the SI in quartiles. RESULTS: Both indicators of structural SES were independently linked to stigma (p = 0.002). For “SI district”, we identified a non-linear relationship with patients from the most deprived quartile feeling less stigmatized compared to those in the second (p < 0.001) or least deprived quartile (p = 0.009). Furthermore, more restrictions of daily life (p < 0.001), unfavorable income (p = 0.009) and seizure freedom in the past 6 months (p = 0.05) were related to increased stigma. A lower “SI neighborhood” was associated with higher stigma (p = 0.002). CONCLUSION: Strategies to reduce epilepsy-related stigma need to consider the sociostructural living environment on different regional levels. Unfavorable relations with the immediate living environment may be directly targeted in patient-centered interventions. Non-linear associations with the structural SES of broader regional levels should be considered in public education programs. Further research is needed to examine possible underlying mechanisms and gain insight into the generalizability of our findings to other populations. Frontiers Media S.A. 2022-08-26 /pmc/articles/PMC9459334/ /pubmed/36091545 http://dx.doi.org/10.3389/fpubh.2022.952585 Text en Copyright © 2022 Hohmann, Berger, Kastell and Holtkamp. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Public Health
Hohmann, Louisa
Berger, Justus
Kastell, Shirley-Uloma
Holtkamp, Martin
Perceived epilepsy-related stigma is linked to the socioeconomic status of the residence
title Perceived epilepsy-related stigma is linked to the socioeconomic status of the residence
title_full Perceived epilepsy-related stigma is linked to the socioeconomic status of the residence
title_fullStr Perceived epilepsy-related stigma is linked to the socioeconomic status of the residence
title_full_unstemmed Perceived epilepsy-related stigma is linked to the socioeconomic status of the residence
title_short Perceived epilepsy-related stigma is linked to the socioeconomic status of the residence
title_sort perceived epilepsy-related stigma is linked to the socioeconomic status of the residence
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9459334/
https://www.ncbi.nlm.nih.gov/pubmed/36091545
http://dx.doi.org/10.3389/fpubh.2022.952585
work_keys_str_mv AT hohmannlouisa perceivedepilepsyrelatedstigmaislinkedtothesocioeconomicstatusoftheresidence
AT bergerjustus perceivedepilepsyrelatedstigmaislinkedtothesocioeconomicstatusoftheresidence
AT kastellshirleyuloma perceivedepilepsyrelatedstigmaislinkedtothesocioeconomicstatusoftheresidence
AT holtkampmartin perceivedepilepsyrelatedstigmaislinkedtothesocioeconomicstatusoftheresidence