Impaired responsibility dimension of self-esteem of Brazilian adolescents with epilepsy.

This study aimed to compare the self-esteem of Brazilian adolescents with epilepsy and Brazilian adolescents without this condition and the correlations between self-esteem of these adolescents with depression and anxiety symptoms. Study participants were 101 adolescents of both sexes, aged 10-19years old, from elementary and high school education. Fifty patients diagnosed with uncomplicated epilepsy attending the pediatric epilepsy clinic of University Hospital composed the case group. The other fifty-one adolescents without this diagnosis were attending public schools in Campinas-SP region. The instruments used were: identification card with demographics and epilepsy data, Multidimensional Self-Esteem Scale, Beck Depression Inventory and Inventory of State-Trait Anxiety - IDATE. A statistically significant result was found in the Responsibility Self-esteem Dimension favoring the control group. Significant correlations between self-esteem scores and anxiety and depression symptoms were also found. The development of a chronic disease such as epilepsy leads to a change in the way the individual perceives himself and the social environment he is inserted, influencing his behavior. The way people with epilepsy experience their seizures is a subjective measure that will control his/her well-being. Childhood and adolescence form the basis for a healthy emotional development; thus, our results show the importance of studying how subjective variables relate to the physical aspects of a chronic disease in these life stages.

Quality of life in epilepsy: a study of Brazilian adolescents.

OBJECTIVE: Our objectives were: to assess the QOL of Brazilian adolescents with epilepsy with a specific QOL assessment tool; to compare the adolescents with epilepsy and healthy adolescents using a generic QOL assessment tool; to correlate the 2 different QOL assessment tools (the generic and the epilepsy-specific); and to correlate QOL scores of the adolescents with epilepsy obtained by both tools with physical, psychological and social variables of the disease. METHODS: Fifty subjects (case group) attending the outpatient clinic of epilepsy of the Clinics Hospital of UNICAMP, Campinas-SP, answered the Brazilian version of the QOL inventory for adolescents with epilepsy--QOLIE-AD-48 and the QOL Questionnaire--WHOQOL-BREF-Portuguese version. Fifty-one subjects (control group) from public schools in Campinas-SP answered only the WHOQOL-BREF. RESULTS: The results showed that adolescents with epilepsy presented a good score of QOL in both tools; overall scores for both groups with WHOQOL-BREF were good, but a statistically significant difference was seen with regards to the Psychological domain of the WHOQOL-BREF favoring the control group. Significant correlations between QOLIE-AD-48 Total and WHOQOL domains were found. Adolescents that were considered seizure-free (P = 0.001), had good perception of seizure control (P = 0.012) and had not had occurrence of seizures in public places (P = 0.001) presented better QOL scores. CONCLUSIONS: Brazilian adolescents with epilepsy may present good QOL scores when they themselves consider the disease as under control; physical, social and especially psychological variables associated to the disease may play an important role in these results. As a generic QOL tool, WHOQOL-BREF was sufficient to allow for a comparison between chronic disease bearers and healthy adolescents and showed that the gap in QOL between both populations is not as extensive as once was thought, probably due to better support and adaptation to the disease.

Self-esteem, social support perception and seizure controllability perception in adolescents with epilepsy.

OBJECTIVE: Compare the self-esteem of adolescents with epilepsy and adolescents without epilepsy and relate it to social support and seizure controllability perception. METHOD: The study sample consisted: case participants (34 subjects) attending the pediatric epilepsy clinic of University Hospital and control participants (30 subjects) from public schools in Campinas-SP. The instruments utilized were: identification card with demographic and epilepsy data, a semi-structured interview on aspects of the disease, and a Self-Esteem Multidimensional Scale. RESULTS: There was no significant difference between the two groups but majority of adolescents with epilepsy presented higher self esteem rate, have knowledge about epilepsy, presented high levels of social support and seizure controllability perception. There was no significant relationship between social support and seizure controllability perception with self-esteem. CONCLUSION: Knowledge about epilepsy, social support such good controllability seizure perception seem are important contingencies for a better evaluation of self esteem in adolescents with epilepsy.

Locus of control, depression, and quality of life in Parkinson's Disease.

People can attribute the source of control of events that involve them either to internal or external factors. Through this view, depression can be defined as a belief that one's own behavior is not effective. In case of chronic diseases, such as Parkinson's Disease, depression is more frequent than in the general population. The present study aimed to assess locus of control orientation and its relation with depression and quality of life in 30 patients with Parkinson's Disease. Results showed positive correlation between external locus orientation and depression and quality of life scores, and negative correlation between internal orientation and depression.

The effect of psychotherapy in patients with PD: a controlled study.

The purpose of this study was to evaluate whether group psychotherapy was effective in improving of quality of life and would decrease the symptoms of anxiety and depression in Parkinson's disease patients. Sixteen subjects, with idiopathic Parkinson's disease recruited from the school clinical Hospital/UNICAMP. Were randomly divided in to two groups, experimental and control. Parkinson's Disease and Quality of Life - PDQL; Beck Depression Inventory - BDI; State-Trait-Anxiety Inventory - STAI were used to evaluate the patients. The statistical analysis showed significant effect of the interaction group vs. time in depression (0.0009), anxiety (<0.0001) and QuoL (0.0018) and positive changes in depression (0.0029), anxiety (0.0009) and QuoL (0.0047) for the treated group.

The Brazilian version of the Quality of Life in Epilepsy Inventory for Adolescents: translation, validity, and reliability.

OBJECTIVE: The aim of this study was to translate and adapt the Quality of Life in Epilepsy Inventory for Adolescents (QOLIE-AD-48) into Brazilian Portuguese, as well as to evaluate the psychometric properties of this Brazilian version. METHODS: The QOLIE-AD-48 Brazilian version was tested with respect to reliability and validity in 93 adolescents with epilepsy. Patients completed the Self-Esteem Inventory (SEI), Children's Depression Evaluation Scale (CDES), and Adverse Events Profile (AEP). A subset of these patients were reexamined after 3-4 weeks to evaluate the test-retest reliability of the inventory. We assessed validity by comparing the QOLIE-AD-48 Brazilian version with external measures. RESULTS: Internal consistency was satisfactory (Cronbach's alpha=0.87). Test-retest reliability was acceptable as well (intraclass correlation coefficient=0.52-0.81). Moreover, the QOLIE-AD-48 Brazilian version was highly correlated with other scales, demonstrating strong validity. CONCLUSIONS: We conclude that the QOLIE-AD-48 Brazilian version has psychometric properties equivalent to those of the original American-English version and is a valid and reliable instrument for assessment of health-related quality of life in adolescents with epilepsy in Brazil or other Portuguese-speaking countries.

A psychosocial view of anxiety and depression in epilepsy.

The aim of this study was to study anxiety and depression in patients with epilepsy and evaluate their relationships with neuroepilepsy and psychological variables. neuroepilepsy and psychological variables. Sixty patients and 60 healthy subjects were interviewed at the outpatient clinic for epilepsy, using the Beck Depression Inventory and State-Trait-Anxiety Inventory. The objective of the semistructured interview was to identify the patients' perception of the disease, self-concept, personal strategies, and perception of seizure control. There was a significant difference in anxiety and depression between the groups, as well as a strong relationship between perception of seizure control and depression and anxiety, independently assessed. Epilepsy was associated with disease (63.4%), mental problems (11.6%), feelings of shame, fear, worry, and low self-esteem (56.6%), and perception of stigma (26.6%). The strategies were: looking for social support, seeking medical treatment, withdrawal, denial, and spiritual support. There was a significant association between psychological symptoms and perception of seizure control, which reinforces the importance of subjective aspects involved in epilepsy.