Stigmatization of patients with epilepsy: a review of the current problem and assessment of the perceived stigma in Bulgarian patients.

No study of stigmatization in patients with epilepsy has thus far been conducted in Bulgaria. Our aim was to assess the perceived stigma of Bulgarian patients with refractory epilepsy (RE) and the factors associated with stigmatization. A study based on questionnaires and a purposeful interview on clinical and social factors were conducted in 94 patients with RE and 70 patients with pharmacosensitive epilepsy (PSE). Stigmatization was found in 43.62% of the participants with RE and in 5.71% of those with PSE. Stigmatization was associated with depression and mental status impairment. In conclusion, stigmatization in Bulgarian patients with RE was confirmed. Stigmatization was frequently severe, especially in cases with concomitant personality and behavioral impairment and depression. The study participants explained the existence of stigmatization as being due to fear of seizures and due to inadequate education on the special features of the disease or on administering first aid during seizures.