title: Comprehensive evaluation of the psychosocial parameters of epilepsy: a representative population-based study in Prey Veng (Cambodia).
abstract: OBJECTIVE
  We conducted a population-based study of epilepsy in Prey Veng (Cambodia) to explore self-esteem, fear, discrimination, knowledge-attitude-practice (KAP), social-support, stigma, coping strategies, seizure-provoking factors, and patient-derived factors associated with quality of life (QOL).
  
  
  METHODS
  The results are based on a cohort of 96 cases and matched controls (n = 192), randomly selected from the same source population. Various questionnaires were developed and validated for internal consistency (by split-half, Spearman-Brown prophecy, Kuder-Richardson 20), content clarity and soundness. Summary, descriptive statistics, classical tests of hypothesis were conducted. Uncorrected chi-square was used. Group comparison was done to determine statistically significant factors, for each domain, by conducting logistic regression; 95% confidence interval (CI) with 5% (two-sided) statistical significance was used.
  
  
  RESULTS
  All questionnaires had high internal consistency. Stress was relevant in 14.0% cases, concealment in 6.2%, denial in 8.3%, negative feelings in public in 3.0%. Mean self-esteem was 7.5, range 0-8, related to seizure frequency. Mean discrimination was least during social interactions. Coping strategies were positive (e.g. look for treatment). Postictal headache, anger, no nearby health facility, etc. were associated with QOL.
  
  
  CONCLUSIONS
  The reliability of our questionnaires was high. A positive social environment was noted with many infrequent social and personal prejudices. Not all populations should (by default) be considered as stigmatized or equipped with poor KAP. We addressed themes that have been incompletely evaluated, and our approach could therefore become a model for other projects.
authors.affiliation: INSERM UMR 1094, Tropical Neuroepidemiology, Limoges, France.
authors.forename: Devender
authors.initials: D
authors.lastname: Bhalla
authors.forename: Kimly
authors.initials: K
authors.lastname: Chea
authors.forename: Hun
authors.initials: H
authors.lastname: Chamroeun
authors.forename: Chan
authors.initials: C
authors.lastname: Vichea
authors.forename: Pierre
authors.initials: P
authors.lastname: Huc
authors.forename: Chan
authors.initials: C
authors.lastname: Samleng
authors.forename: Robert
authors.initials: R
authors.lastname: Sebbag
authors.forename: Daniel
authors.initials: D
authors.lastname: Gérard
authors.forename: Michel
authors.initials: M
authors.lastname: Dumas
authors.forename: Sophal
authors.initials: S
authors.lastname: Oum
authors.forename: Michel
authors.initials: M
authors.lastname: Druet-Cabanac
authors.forename: Pierre-Marie
authors.initials: PM
authors.lastname: Preux
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D002160:Cambodia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D018672:Community Health Planning; D004827:Epilepsy / Q000150:complications / Q000453:epidemiology* / Q000523:psychology*; D005239:Fear / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D015203:Reproducibility of Results; D012649:Self Concept; D012944:Social Support; D013240:Stereotyping; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Cambodia; Discrimination; Epilepsy; Fear; Psychosocial; Quality of life; Self-esteem; Social support