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Editorial

Dr J S Yadav

PSYCHOSOCIAL ISSUES OF ADOLESCENT WITH EPILEPSY

 


 

Epilepsy is a pervasive disorder that associated with many other problems like behavioural, academic, and social difficulties. 25% of people with epilepsy have social stigma as result of their epilepsy1. Epilepsy affects 50 million people worldwide, although most of them achieve Seizure control but still many people living with epilepsy continue face social stigma and the negative attitudes toward their illness. The adolescent living with epilepsy leads stress, loneliness and social avoidance at school and on the workplace, the important finding that 71% reported have the victims of teasing while they were at secondary school, many of them feelings of apprehension that others are more concern about their epilepsy, especially members of the opposite sex, and employers2. Many of critique people can described supportive, positive relationships with them and their families and close friends, the parental over protection also reported by adolescent with epilepsy being a significant problem 3. Though adolescence is a period of profound biological, emotional, intellectual, and social transformation and adolescent emerges from this period with a positive self-image, a strong sense of identity, and the capacity for intimacy with peers and independence from the family. The adolescents are also becoming aware of themselves as individuals, separate from their parents, and are presented with the challenges of independent thinking and action, during this phase adolescent go through a variety of emotions, including shame, denial, anger, and sadness. The adolescent faces the usual challenges of this life stage along with the added stress of issues surrounding epilepsy, the adolescent females with epilepsy may under more stress than normal adolescent females. They and their families have concerns about their social interaction, expansion of independence, and sexuality.

When educating the adolescent and her family, carer should consider the cognitive function of the adolescent, family readiness, changes in seizure control during puberty and menarche, adolescent behavior and antiepileptic drugs, and family education. Carer must be familiar with questions that parents and siblings of a young child with epilepsy may have concerning sexuality issues. Perhaps the most effective time to start education on sexuality issues is during preadolescence (6-12 years) and young adolescence. It is important to provide clear, concise information to children and adolescents. Taking one's time, actively listening, being knowledgeable, being open and sincere, providing balanced information and understandable answers, anticipating and facilitating questions, and always following-up on earlier communication enhance effective communication. Research should be conducted to examine the needs and intervention for adolescents with epilepsy so care and other health professionals can provide more effective care to these adolescents and their families4.The effect on public education is primarily short-term, while change over the long-term in attitudes and inaccurate beliefs have not presently been proven effective. School education programming demonstrates improved knowledge and attitude a month after a classroom intervention, but persisting change over a longer period of time has not been evaluated. The adult psycho-educational programs for adults with epilepsy improve knowledge, coping skills and level of felt stigma. However these gains have not demonstrated persistence over time. Myths, misconceptions and misunderstandings about epilepsy continue and programs aimed at increasing knowledge and reducing negative public attitudes should be enhanced. 2 Our role as medical providers is to provide some perspective to the illness and help guide our adolescent patient through the tumultuous emotions of grieving and acceptance. We must provide a foundation of assistance and emotional support, as well as medical knowledge with a firm but compassionate hand; we can help them cope with their disorder. The adolescent women with epilepsy should be educated about effects of antiepileptic drugs (AEDs) on hormones, contraception, and bone health. We should also deal real psychosocial issues and co morbidities of epilepsy, including quality of life, school performance, depression, migraine headaches, social stigma, and lifestyle changes. Additionally, many subjects were critical of the medical profession and support services for people with epilepsy, complaining that they were not meeting their needs appropriately. Most subjects reported feelings of apprehension about telling others about their epilepsy, especially members of the opposite sex, and potential employers. Most described supportive, positive relationships with their families and close friends, and parental over-protection was rarely reported by them as being a significant problem. In addition, an estimate of subjects' adjustment to epilepsy was obtained which appears to indicate that the majority were coping well with their condition, even though it may have been resented by some of them3. Therefore psychosocial issues of epilepsy in adolescents female are very challenging task specially fighting to stigma, however these can be overcome by psychosocial education, training of governmental and nongovernmental organization and management plan.

References

1.        Rodenburg R, Wagner JL, Austin JK, Kerr M, Dunn DW. Psychosocial issues for children with epilepsy. Epilepsy Behav. 2011;22(1):47-54.

2.        Bandstra NF, Camfield CS, Camfield PR. Stigma of epilepsy. Can J Neurol Sci. ;35(4):436-40.

3.        Wilde M, Haslam C. Living with epilepsy: a qualitative study investigating the experiences of young people attending outpatients clinics in Leicester. Seizure 1996 ;5(1):63-72.

4.        Mims J. Sexuality and related issues in the preadolescent and adolescent female with epilepsy. J Neurosci Nurs. 1996;28(2):102-106. Review.