# Stigma, overprotection, and suicidal ideation in epilepsy: a cross-sectional study on psychosocial predictors

## TL;DR

This study shows that stigma and depression are linked to suicidal thoughts in people with epilepsy, and addressing these factors could help reduce suicide risk.

## Contribution

This is the first study to link stigma, overprotection, and suicidality in epilepsy.

## Key findings

- Felt stigma is significantly associated with suicidal ideation in epilepsy.
- Depression mediates the relationship between stigma and suicide risk.
- Perceived overprotection correlates with stigma but not directly with suicidality.

## Abstract

•Felt stigma is significantly associated with suicidal ideation in epilepsy.•Depression mediates the effect of stigma on suicide risk among people with epilepsy.•Perceived overprotection correlate with stigma but not directly with suicidality.•This is the first study linking stigma, overprotection, and suicidality in epilepsy.•Addressing psychosocial factors may help reduce suicide risk in epilepsy care.

Felt stigma is significantly associated with suicidal ideation in epilepsy.

Depression mediates the effect of stigma on suicide risk among people with epilepsy.

Perceived overprotection correlate with stigma but not directly with suicidality.

This is the first study linking stigma, overprotection, and suicidality in epilepsy.

Addressing psychosocial factors may help reduce suicide risk in epilepsy care.

Patients with epilepsy (PWE) are at elevated risk for suicide, with psychosocial factors such as felt stigma and perceived overprotection contributing to this vulnerability. This cross-sectional study examined the associations among suicidal ideation, felt stigma, and perceived overprotective behaviors in 92 adult PWE not currently receiving psychiatric treatment. Participants completed self-report measures including the Felt Stigma Scale (FSS), Perceived Overprotection Scale (POS), Beck Depression Inventory-II (BDI-II), and Suicide Probability Scale (SPS). SPS scores were significantly correlated with FSS (r = 0.405, p < 0,001) and BDI-II (r = 0.765, p < 0.001), while FSS and POS were also correlated (r = 0.399, p < 0.001). POS was not directly associated with SPS. In hierarchical regression, FSS was a significant predictor of suicidal ideation (p < 0.001), but BDI-II emerged as the strongest predictor (p < 0.001), explaining 58 % of the variance in SPS scores. These findings highlight the mediating role of depression in the relationship between felt stigma and suicidal ideation, and suggest that addressing felt stigma and depressive symptoms in epilepsy care may help reduce suicide risk.