Self-efficacy in seizure management differentially correlated with quality of life in persons with epilepsy depending on seizure recurrence and felt stigma

Purpose: We determined whether self-efficacy in seizure management differentially correlated with health-related quality of life (HRQoL) in persons with epilepsy depending on seizure recurrence and felt stigma. Methods: This cross-sectional study was conducted in 312 adults with epilepsy. To determine which risk factors affected the benefits of self-efficacy for HRQoL, an analysis of covariance with an interaction term was used. The Quality of Life in Epilepsy Inventory-10 (QOLIE-10), the Epilepsy Self-Efficacy Scale (ESES), the Stigma Scale for Epilepsy (SS-E), and the Hospital Anxiety and Depression Scale (HADS) were assessed. Results: QOLIE-10 scores positively correlated with ESES score and employed status, but negatively correlated with HADS scores, SS-E score >= 1, seizure frequency, and antiepileptic drug (AED) polytherapy. There were significant interaction effects between ESES score and 2-year seizure status (p = 0.025) or SS-E score >= 1 (p = 0.009) on QOLIE-10 scores. Self-efficacy in epilepsy management correlated with QOLIE-10 scores only in subjects that had experienced uncontrolled seizures (B = 0.090, p = 0.003) or refractory seizures (B = 0.158, p = 0.020) and in subjects with felt stigma (SS-E >= 1) (B = 0.183, p < 0.001). Contrastingly, generalized tonic-clonic seizure recurrence (p = 0.420), AED polytherapy (p = 0.667), depressive symptoms (p = 0.663), and anxiety (p = 0.503) did not interact with self-efficacy. Conclusions: The relationship between epilepsy self-efficacy and overall HRQoL may differ depending on seizure recurrence and felt stigma. Our findings would be helpful for designing psychosocial interventions to improve HRQoL in persons with epilepsy.