Severity and predictors of internalised stigma among people with epilepsy in Poland.

Aim of study: This study was aimed at exploring the intensity and associated factors of internalised stigma (or self-stigma) among Polish patients diagnosed with epilepsy.

Clinical rationale for study: People with chronic diseases are commonly stigmatised in society. Some patients tend also to self-stigmatise, i.e. apply to oneself, accept and internalise negative stereotypes about their condition, which can result in a variety of adverse health outcomes and an impaired quality of life.

Material and methods: A total of 120 patients with epilepsy treated in the Institute of Psychiatry and Neurology in Warsaw were recruited. They were administered a set of self-report measures assessing internalised stigma, social network, material well-being, cultural capital, and level of disability. Socio-demographic and health-related data was also recorded. Hierarchical linear multiple regression analysis was used to identify factors independently related to the severity of internalised stigma.

Results: 66 (55.0%) participants reported experiencing minimal or no internalised stigma, 34 (28.3%) reported mild, 18 (15.0%) moderate, and two (1.7%) severe internalised stigma. In the final regression model, independent predictors of lesser internalised stigma turned out to be a larger and supportive social network (β = -0.36, p < 0.01) and greater cultural capital (β = -0.17, p < 0.05). Stronger internalised stigma was predicted when three or more antiseizure medications were used (β = 0.33, p < 0.01), and when there were higher levels of disability (β = 0.25, p < 0.01).

Conclusions: Although only a minority of patients with epilepsy in our sample reported moderate or high levels of internalised stigma, this remains a major clinical and social problem. These research results highlight the importance of personal resources (such as a supportive social network and high cultural capital) as factors protecting against internalising epilepsy stigma. Also, the indicators of the severity of the disease (such as the number of antiseizure medications used and the degree of disability) have been predictive factors associated with greater vulnerability to the development of self-stigmatised identity.

Clinical implications: In clinical practice, patients with epilepsy should be screened for their tendency to self-stigmatise. There is a need to devise effective interventions to target internalised stigma associated with epilepsy, and to incorporate them into comprehensive therapeutic programmes for patients with this diagnosis.