Stigma scale of epilepsy - Validation process

Purpose: To validate a Stigma Scale of Epilepsy (SSE). Methods: The SSE was completed by 40 adult with epilepsy attending an Outpatient Epilepsy Clinic at the University Hospital of UNICAMP, and by 40 people from the community. People were interviewed on an individual basis; a psychologist read the questions to the subjects who wrote the answers in a sheet. The procedure was the same for all the subjects and completion took around ten minutes. Results: The SSE has 24 items. The internal consistency of the SSE showed alpha. Cronbach's coefficient 0.88 for the patients with epilepsy and 0.81 for the community. The overall mean scores of the Stigma Scale of Epilepsy formula were: 46 (SD=18.22) for patients and 49 (SD=13.25) for the community where a score of 0 would suggest no stigma, and 100 maximum stigma. Discussion: The SSE has satisfactory content validity and high internal consistency. It allows the quantification of the perception of stigma by patients and people from community; this can then be used for interventional studies, such as mass media campaign in minimizing the negative facets of stigma

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. (c) 2005 Elsevier Inc. All rights reserved.8123223

Neuroimaging changes in mesial temporal lobe epilepsy are magnified in the presence of depression

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Objective: The aim of this study was to investigate differences in gray matter volume between patients with mesial temporal lobe epilepsy (MTLE) with and without depression using voxel-based morphometry. Method: We included 48 adults with refractory MTLE (31 women, 39.18 +/- 8.4 years) and 96 healthy controls (75 women, 37.11 +/- 8.9 years). For the psychiatric evaluation, the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Axis I, was used for the diagnosis of depression, and the Beck Depression Inventory, for the determination of symptom intensity. All patients underwent an MRI scan. Patients were separated into two groups: those with MTLE with depression (n = 24) and those with MILE without depression (n=24). We performed voxel-based morphometric analysis, comparing patients with controls using the t test. Results: The number of areas of gray matter volume loss was higher in patients with MTLE with depression than in those with MTLE without depression. Conclusions: The evidence of more widespread gray matter volume loss in patients with MTLE and depression calls our attention to the importance of timely recognition and treatment of depression in patients with MTLE and also to the bidirectional relationship between the two disorders and their frequent co-occurrence. (C) 2010 Elsevier Inc. All rights reserved.193422427Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)FAPESP [05/56578-4, 07/51280-2

Pre-surgery expectations and post-surgery life-changing validation process

This study aimed to validate two instruments that evaluate presurgery expectations and post-surgery life changes of people with epilepsy. The expectations questionnaire comprises 18 yes/no questions and the life changes questionnaire 25 yes/no questions, which includes the 18 questions of the expectations questionnaire plus seven negative questions, considering that the Surgery could have a negative effect on the patient quality of life. There were also questions asking the patients to state if they consider the Surgery to be a success or a failure, and about the frequency of seizures and their intensity. Patients were interviewed in three different phases: pre-surgery, post-surgery I (six months after surgery) and post-surgery 2 (12 months after Surgery). The internal consistency of the instruments showed a general Kuder-Richardson coefficient of 0.855 (pre-surgergy), 0.833 (post-surgery 1), 0.756 (post-surgery 2), showing that both instruments have a satisfactory content validity and high internal consistency. In this context, the answers obtained in this Study are important because they represent the development of a complete set of categorical instruments to evaluate pre-surgery epilepsy expectations and post-surgery life changes.10429029

Prejudice towards chronic diseases: Comparison among epilepsy, AIDS and diabetes

Introduction: Diseases have an additional negative meaning but with different magnitude. Epilepsy is considered a stigmatizing condition; however its magnitude is unknown in our society, a limited-resource country, as Brazil. Purpose: To compare the stigma perception of epilepsy to other two chronic conditions: AIDS and diabetes in the city of Campinas, Brazil. Methods: We interviewed people in two situations: on the streets (145 randomly selected people) and during a Meeting of Epilepsy (86 people). We asked three questions 'What score would you rate for the prejudice that general population has towards: epilepsy, AIDS and diabetes'. The score ranges from 0 (no prejudice) to 10 (maximum prejudice), and was displayed to the interviewee in the format of a ruler. Results: The median (upper and lower 95% confidence interval) prejudice score of lay people was 9 (7.8-8.6) for AIDS, 7 (6.1-7.0) for epilepsy and 2 (2.5-3.5) for diabetes. The median prejudice score of people with epilepsy and relatives was 9 (6.9-8.1) for AIDS, 7 (6.4-7.5) for epilepsy and 2.5 (2.9-4.2) for diabetes. Discussion: There is a difference in the perception of prejudice towards people with chronic diseases; AIDS had the highest level of stigma and diabetes the lowest, and epilepsy was in the intermediate position but closer to AIDS. (c) 2007 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.16432032

Epilepsy stigma perception in an urban area of a limited-resource country

Objective. To estimate the perception of stigma attached to epilepsy in an urban society of a limited-resource country, Brazil. Methods. We applied a validated Stigma Scale of Epilepsy (SSE) cross-sectionally to 1850 people from all regions within the metropolitan area of Campinas, following a sampling selection methodology (95% confidence interval and error of 2.3). Results. The overall score for epilepsy stigma perception was 42 (range, 3-98; SID, 14). The SSE score for women was higher (43) than that for men (40). With respect to religion, Spiritism had the lowest SSE score (35) compared with Catholic, Evangelical, other, and no religion. Level of education was inversely related to SSE scores; illiterate people had higher SSE scores (45) than people with higher education (37). Conclusion. This is one of the first systematic assessments of epilepsy stigma perception in an urban area of a limited -resource country. It was found that the magnitude of stigma is different within segments of the local society, highlighting that sociocultural factors such as gender, religion, and level of education may be important predictors of stigma. (c) 2007 Elsevier Inc. All rights reserved.111253

Hydrolysed whey protein reduces muscle damage markers in Brazilian elite soccer players compared with whey protein and maltodextrin. A twelve-week in-championship intervention

Health parameters, performance and body composition effects produced by twelve weeks of intervention with hydrolysed whey protein in elite soccer players from a Brazilian team during an actual championship were compared. Twenty-four players were divided into three groups according to supplement: whey protein (WP), hydrolysed whey protein (HWP), or a non-protein placebo (maltodextrin, MALTO). Biochemical, anthropometric and performance tests were applied on week 0 and week 12 of the intervention. Intervention with hydrolysed whey protein resulted in significant decreases in the muscle damage indicators, creatine kinase (-42%) and lactate dehydrogenase (-30%), compared with increases in the MALTO group. Supplementation with whey protein showed no significant changes in these indicators compared with the MALTO group. Muscle mass showed no changes, and physical performance in an aerobic test was decreased in the HWP group compared with the MALTO and WP groups. These data suggest that the consumption of HWP decreases muscle damage. (C) 2013 Elsevier Ltd. All rights reserved.341192