title: Self-esteem in adolescents with epilepsy: Psychosocial and seizure-related correlates.
abstract: This study evaluated self-esteem in adolescents with epilepsy and its association with psychosocial and disease-related variables.
  
  
  
  This was a cross-sectional study with patients enrolled between January and June 2010. Culture-Free Self-Esteem Inventory for Children (CFSEI-2) was administered to 140 children with epilepsy and 50 children with asthma, aged 10-18years attending mainstream schools.
  
  
  
  Adolescents with epilepsy had a significantly lower overall self-esteem score when compared with those with asthma, 17±5.21 versus 19.4±3.83, respectively (P=0.005). Thirty-one (22.1%) children with epilepsy compared with 4 (8.3%) with asthma had overall self-esteem score below the cutoff (P=0.034). There was a significant correlation between overall self-esteem score and duration of epilepsy, Hospital Anxiety and Depression Scale (HADS) anxiety score, HADS depression score, and Strengths and Weaknesses of ADHD symptoms and Normal-Behaviors (SWAN) rating combined score. The impact of various correlates on individual domains was not identical. Independent factors associated with low overall self-esteem were HADS depression score (OR: 1.62; 95% CI: 1.2, 2.2; P=0.002), duration of epilepsy (OR: 1.4; 95% CI: 1.04, 1.88; P=0.024), and father employment status economically inactive (OR: 11.9; 95% CI: 1.07, 125; P=0.044). Seizure-free ≥12months was a favorable factor that was less likely to be associated with low self-esteem (OR: 0.14; 95% CI: 0.02, 0.81; P=0.028).
  
  
  
  Self-esteem was compromised in adolescents with epilepsy. A significant correlation between self-esteem and psychological comorbidities was demonstrated. Enhancing social support and education programs may improve the self-esteem and, ultimately, the lives of adolescents living with epilepsy.
authors.affiliation: Department of Paediatrics and Adolescent Medicine, Tuen Mun Hospital, Hong Kong. Electronic address: kwonglk@ha.org.hk.
authors.forename: Karen Ling
authors.initials: KL
authors.lastname: Kwong
authors.affiliation: Department of Paediatrics and Adolescent Medicine, Tuen Mun Hospital, Hong Kong.
authors.forename: David
authors.initials: D
authors.lastname: Lam
authors.affiliation: Department of Paediatrics and Adolescent Medicine, Tuen Mun Hospital, Hong Kong.
authors.forename: Sarah
authors.initials: S
authors.lastname: Tsui
authors.affiliation: Department of Paediatrics and Adolescent Medicine, Tuen Mun Hospital, Hong Kong.
authors.forename: Mary
authors.initials: M
authors.lastname: Ngan
authors.affiliation: Department of Paediatrics and Adolescent Medicine, Tuen Mun Hospital, Hong Kong.
authors.forename: Brian
authors.initials: B
authors.lastname: Tsang
authors.affiliation: Department of Child Psychiatry, Castle Peak Hospital, Hong Kong.
authors.forename: Tai Sum
authors.initials: TS
authors.lastname: Lai
authors.affiliation: Department of Child Psychiatry, Castle Peak Hospital, Hong Kong.
authors.forename: Siu Man
authors.initials: SM
authors.lastname: Lam
mesh_terms: D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D004827:Epilepsy / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D012640:Seizures / Q000523:psychology*; D012649:Self Concept; D012944:Social Support
keywords: Adolescents; Epilepsy; Psychiatric disorders; Self-esteem