Resilience is conceptually characterized as a dynamic process encompassing positive adaptation in the context of significant adversity. Our goal was to assess the resilience in people with epilepsy (PWE) and how it impacts longitudinally on psychosocial factors, with a particular focus on the manifestation of stigmatization-related feelings. We consecutively enrolled 78 adults PWE (42.5 ± 16.2 years old); among them 36 (46.1 %) were seizure-free. All subjects completed at baseline (T0) the Resilience Scale (RS-14) and questionnaires for the assessment of depressive symptoms, anxiety and quality of life: respectively, Beck Depression Inventory-II (BD-II), Generalized Anxiety Disorder-7 (GAD-7) and QOLIE-31 (Q31). All patients were followed up prospectively and re-evaluated after 6–22 months (T1; mean: 14 ± 8 months; median 14 months); at follow up they also completed the Stigma Scale of Epilepsy (SSE) for the assessment of the stigma associated with epilepsy. We correlated resilience values with all psychosocial scores at T0 and T1. Factors associated with resilient and vulnerable outcomes were identified. Finally, a multiple stepwise regression analysis was applied to identify predictors for resilience and stigma perception. The results showed for the RS-14 score a significant direct correlation with the Q31 (p < 0.001) and an inverse correlation with the depressive and anxiety symptoms at both times (T0 and T1), as evaluated with BDI-II (p < 0.001) and GAD-7 (p < 0.001). Finally, we found a significant inverse correlation between RS-14 at T0 and the levels of stigmatization assessed with SSE at T1 (p =.015). Using a multiple stepwise regression analysis separately for resilience and stigma perception, depressive symptoms turned out as the best predictors for both variables. Finally, considering longitudinal evaluation we did not observe significant changes in depressive and anxious symptoms, despite a significant reduction in the total number of seizures at follow up. Our study showed that depressive symptoms, anxiety and quality of life were significantly associated with resilience in PwE. Finally, as a novel finding resilience was proved to affect the perception of stigma related to epilepsy more than seizures.

中文翻译：

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成人癫痫患者的心理弹性和心理社会因素：一项纵向研究

复原力在概念上被描述为一个动态过程，包括在重大逆境中积极适应。我们的目标是评估癫痫患者 (PWE) 的恢复能力及其对心理社会因素的纵向影响，特别关注与耻辱相关的感受的表现。我们连续招募了 78 名成人 PWE（42.5 ± 16.2 岁）；其中 36 例（46.1%）没有癫痫发作。所有受试者在基线 (T0) 时均完成了心理弹性量表 (RS-14) 和问卷调查，以评估抑郁症状、焦虑和生活质量：分别为贝克抑郁量表 II (BD-II)、广泛性焦虑症 7 ( GAD-7) 和 QOLIE-31 (Q31)。所有患者均进行前瞻性随访，并在 6-22 个月后重新评估（T1；平均：14 ± 8 个月；中位 14 个月）；在随访中，他们还完成了癫痫耻辱量表（SSE），以评估与癫痫相关的耻辱感。我们将复原力值与 T0 和 T1 时的所有社会心理评分相关联。确定了与弹性和脆弱结果相关的因素。最后，应用多重逐步回归分析来确定复原力和耻辱感的预测因素。结果显示，RS-14 评分与 Q31 显着正相关（p < 0.001），并且与 BDI-II 评估的两个时间（T0 和 T1）的抑郁和焦虑症状呈负相关（p < 0.001） ) 和 GAD-7 (p < 0.001)。最后，我们发现 T0 时的 RS-14 与 T1 时 SSE 评估的污名化水平之间存在显着的负相关 (p = .015)。分别对复原力和耻辱感进行多元逐步回归分析，结果发现抑郁症状是这两个变量的最佳预测因子。最后，考虑到纵向评估，尽管随访时癫痫发作总数显着减少，但我们没有观察到抑郁和焦虑症状的显着变化。我们的研究表明，抑郁症状、焦虑和生活质量与 PwE 的复原力显着相关。最后，作为一项新颖的发现，复原力被证明比癫痫发作更能影响与癫痫相关的耻辱感。