title: Knowledge, attitudes and practices regarding epilepsy in the Kingdom of Bhutan.
abstract: To assess the knowledge, attitudes and practices of epilepsy among healthcare workers (HCWs) and people with epilepsy (PWE) living in Bhutan.
  
  
  
  A survey with similar questions was distributed to HCWs and PWE (2014-2015). Responses were compared between the two groups. A Stigma Scale in Epilepsy Score was tested for an independent association with patient age, sex, years of education and presence of seizure freedom using regression models.
  
  
  
  PWE (n=177), when compared to HCWs (n=75), were more likely to believe that epilepsy is contagious; epilepsy results from karma or past actions; PWE need help in school; and people with epilepsy have spiritual powers (p<0.05 for each comparison). Among people with epilepsy, a higher stigma score was independently associated with lower educational attainment (p=0.006) and presence of a seizure in the prior year (p=0.013), but not age, sex or anti-epileptic drug side effects.
  
  
  
  While knowledge of epilepsy was overall fairly high, PWE more often held certain stigmatizing beliefs, including theories of contagion and a relationship between seizures and spiritual powers. Higher educational level and seizure freedom were associated with lower stigma, underscoring their importance in stigma reduction.
authors.affiliation: Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Kate
authors.initials: K
authors.lastname: Brizzi
authors.affiliation: Department of Psychiatry, Jigme Dorji Wangchuck National Referral Hospital, Bhutan.
authors.forename: Sonam
authors.initials: S
authors.lastname: Deki
authors.affiliation: Department of Psychiatry, Jigme Dorji Wangchuck National Referral Hospital, Bhutan.
authors.forename: Lhab
authors.initials: L
authors.lastname: Tshering
authors.affiliation: Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Clark
authors.affiliation: Department of Psychiatry, Jigme Dorji Wangchuck National Referral Hospital, Bhutan.
authors.forename: Damber K
authors.initials: DK
authors.lastname: Nirola
authors.affiliation: Harvard T.H. Chan School of Public Health, Boston, MA, USA.
authors.forename: Bryan N
authors.initials: BN
authors.lastname: Patenaude
authors.affiliation: Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Erica D
authors.initials: ED
authors.lastname: McKenzie
authors.affiliation: Harvard T.H. Chan School of Public Health, Boston, MA, USA.
authors.forename: Hannah C
authors.initials: HC
authors.lastname: McLane
authors.affiliation: Massachusetts General Hospital, Boston, MA, USA Harvard Medical School, Boston, MA, USA.
authors.forename: Sydney S
authors.initials: SS
authors.lastname: Cash
authors.affiliation: Department of Psychiatry, Jigme Dorji Wangchuck National Referral Hospital, Bhutan.
authors.forename: Chencho
authors.initials: C
authors.lastname: Dorji
authors.affiliation: Massachusetts General Hospital, Boston, MA, USA Harvard Medical School, Boston, MA, USA fmateen@partners.org.
authors.forename: Farrah J
authors.initials: FJ
authors.lastname: Mateen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001631:Bhutan; D004827:Epilepsy / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010361:Patients / Q000523:psychology*; D057545:Social Stigma; D012959:Socioeconomic Factors; D013240:Stereotyping; D011795:Surveys and Questionnaires
keywords: Awareness; Bhutan; Epilepsy; Neurology; Social stigma; Traditional medicine