Extrinsic Determinants of Quality of Life in Adolescents Living with Epilepsy and The Implications for Clinical Psychology

Epilepsy is a global health care concern affecting an estimated 50-70 million people worldwide and accounting for 0.75% of the global burden of disease. Adolescents living with epilepsy have concerns beyond seizures, which impact their psychological well-being and, by extension, their Quality of Life (QOL). This study explored family factors, educational institutions, peer acceptance and socialization, and stigma as extrinsic determinants of QOL among adolescents living with epilepsy and the implications for clinical psychology.  A mixed-methods research approach with an explanatory sequential design was employed. Data were collected from 103 participants aged 13-18 years attending the Kenya Association for the Welfare of People Living with Epilepsy (KAWE) clinics, using the Quality of Life in Epilepsy for Adolescents standardized tool (QOLIE-AD-48). Qualitative data was collected through focus group discussions, complementing the quantitative findings by providing context-rich narratives that illuminated how adolescents perceived and navigated their experiences. Social support subscale scored the highest M=72.82, SD=22.68, school behavior M=56.19, SD=22.70, and stigma the lowest M= 43.41, SD=15.06. Social support subscale highlighted the critical role of family and peer support in promoting adolescents’ well-being. Cognitive, social, and emotional challenges in educational institutions were often exacerbated by limited institutional support and persistent absenteeism, while peer acceptance and socialization emerged as a vital yet vulnerable domain, with adolescents frequently reporting social isolation, reduced self-esteem, and stigmatization. Internalized and enacted stigma emerged as a cross-cutting issue affecting identity, mental health, and treatment adherence.  Family cohesion, teacher understanding, peer inclusion, and societal attitudes were key themes that influenced daily life and self-perception, highlighting the challenges faced by this population. Clinical psychologists should address these challenges through tailored interventions, school-based support, peer relationship enhancement, stigma reduction, cognitive rehabilitation, and culturally sensitive care to improve the psychological well-being and enhance the QOL of adolescents living with epilepsy. Key words: Epilepsy, Adolescence, Quality of life, Extrinsic determinants, Kenya