Epilepsy stigma in Saudi Arabia: The roles of mind-body dualism, supernatural beliefs, and religiosity

Abstract

Introduction: The stigma of epilepsy continues to negatively impact people with epilepsy (PWE) in many Arab Middle Eastern countries, including Saudi Arabia. Socioreligious, cultural, and philosophical ideas prevalent in the region may contribute to the underpinnings of stigma toward PWE, but this has not been sufficiently studied.

Materials and methods: This study recruited a convenience sample of people without epilepsy from clinic waiting rooms and through social media. Participants completed a questionnaire with questions about demographics, mind-body dualism (MBD), supernatural beliefs (SB), attitudes toward epilepsy (ATE), and religiosity.

Results: A total of 210 participants were recruited. Analysis of variance (ANOVA) showed a significant difference in the mean total ATE scores, indicating better ATE with higher education (p < 0.001). Despite the relatively high level of education and a high proportion of participants with medical training, only slightly more than half rejected the possibility that demonic possession may be a cause of epilepsy. Attitudes toward epilepsy were correlated with MDB and SB but not with religiosity. Mind-body dualism and religiosity correlated significantly with negative attitudes toward PWE (p < 0.05). A linear regression model using ATE as the dependent variable and MDB, SB, and educational level as independent variables significantly predicted ATE (F = 15.6, p < 0.001, R2 = 0.24), although SB dropped out as a predictor of ATE in that model. Another regression used SB as the dependent variable, and MBD, religiosity, and educational level as independent variables were also significant with all three variables predicting SB (F = 64.0, p < 0.001).

Conclusions: Mind-body dualism was related to the cognitive process leading to supernatural misconceptions about epilepsy and negative attitudes toward PWE in Saudi Arabia. Although misconceptions that supernatural possession was the cause of epilepsy (justifying treatment by religious healing) and was likely derived from prevalent religious beliefs of the region, religiosity was not associated with negative attitudes toward PWE. The merits and efficacy of an intervention focused on reducing the negative effects of MBD and SB on ATE warrants further investigation.

Keywords: Cross-cultural psychiatry; Dualism; Epilepsy; Religiosity; Stigma.