Self-esteem in adolescents with epilepsy: Psychosocial and seizure-related correlates

- Adolescents with epilepsy when compared to those with asthma had lower overall self-esteem scores.
- More adolescents with epilepsy when compared to those with asthma had self-esteem scores below cut-off.
- Overall self-esteem scores correlated with duration of epilepsy, anxiety score, depression score and ADHD combined score.
- Low overall self-esteem was associated with high depression score, long duration of epilepsy and father unemployed.
- Seizure free ≥ 12 months was a favorable factor for overall self-esteem.

PurposeThis study evaluated self-esteem in adolescents with epilepsy and its association with psychosocial and disease-related variables.MethodsThis was a cross-sectional study with patients enrolled between January and June 2010. Culture-Free Self-Esteem Inventory for Children (CFSEI-2) was administered to 140 children with epilepsy and 50 children with asthma, aged 10-18 years attending mainstream schools.ResultsAdolescents with epilepsy had a significantly lower overall self-esteem score when compared with those with asthma, 17 ± 5.21 versus 19.4 ± 3.83, respectively (P = 0.005). Thirty-one (22.1%) children with epilepsy compared with 4 (8.3%) with asthma had overall self-esteem score below the cutoff (P = 0.034). There was a significant correlation between overall self-esteem score and duration of epilepsy, Hospital Anxiety and Depression Scale (HADS) anxiety score, HADS depression score, and Strengths and Weaknesses of ADHD symptoms and Normal-Behaviors (SWAN) rating combined score. The impact of various correlates on individual domains was not identical. Independent factors associated with low overall self-esteem were HADS depression score (OR: 1.62; 95% CI: 1.2, 2.2; P = 0.002), duration of epilepsy (OR: 1.4; 95% CI: 1.04, 1.88; P = 0.024), and father employment status economically inactive (OR: 11.9; 95% CI: 1.07, 125; P = 0.044). Seizure-free ≥ 12 months was a favorable factor that was less likely to be associated with low self-esteem (OR: 0.14; 95% CI: 0.02, 0.81; P = 0.028).ConclusionSelf-esteem was compromised in adolescents with epilepsy. A significant correlation between self-esteem and psychological comorbidities was demonstrated. Enhancing social support and education programs may improve the self-esteem and, ultimately, the lives of adolescents living with epilepsy.