International differences in psychosocial well-being: a comparative study of adults with epilepsy in three countries.

Whilst studies from several countries illustrate the universality of psychosocial difficulties connected with an epilepsy diagnosis, there is a marked lack of empirical research findings on the subject of how different national populations compare on the same measuring instruments. This study reports on comparisons of the psychosocial well-being of samples of adults with epilepsy drawn from Britain (n = 392), the United States (n = 420) and New Zealand (n = 138) using scales assessing self esteem, life fulfilment, social and interpersonal difficulty, general physical health, worries and emotional well-being. The Americans with epilepsy revealed significantly lower levels of well-being than both the New Zealanders and the British. Using the multivariate statistical methods of discriminant and cluster analysis, the scales which were especially predictive of nationality were shown to be life fulfilment, worries, negative affect, and (to a lesser extent) general physical health. Differences between the three national groups were not apparent with regard to self esteem, social difficulty and positive affect. Some possible explanations for the results obtained are put forward. The findings imply that nation-specific variables should be addressed in studies of quality of life and epilepsy, and their effect alongside intra-individual factors within other quality of life domains be ascertained.