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Social outcome and psychiatric comorbidity of generalized epilepsies – A case‐control study
Author(s) -
Gesche Joanna,
Antonson Sussie,
Dreier Julie Werenberg,
Christensen Jakob,
Beier Christoph Patrick
Publication year - 2021
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/epi.16870
Subject(s) - juvenile myoclonic epilepsy , comorbidity , cohort , idiopathic generalized epilepsy , psychiatry , epilepsy , medicine , danish , generalized epilepsy , workforce , pediatrics , psychology , childhood absence epilepsy , linguistics , philosophy , economics , economic growth
SUMMARY Objective To investigate social outcome and psychiatric comorbidity of patients with idiopathic/genetic generalized epilepsies (IGEs) and its subtypes (epilepsy with generalized tonic‐clonic seizures alone [EGTCS], juvenile absence epilepsy [JAE], and juvenile myoclonic epilepsy [JME]). Methods A cohort of 402 adult patients with IGE from the Danish island Funen was matched with 4020 randomly selected geography‐, age‐, and sex‐matched controls via the Danish Civil Registration System. Based on register data, we compared social status measured by cohabitant status, educational attainment, income, affiliation to labor market, and psychiatric comorbidity. Results As compared to controls, patients with IGE had similar cohabitant status but fewer children (no children: 59.0% vs 50.9%), and lower educational level (primary school only: 46.0% vs 37.3%), employment rate (outside of workforce: 56.7% vs 46.5%), and income (low income: 32.6% vs 24.9%) ( P < 0.001 for all comparisons). Having IGE was associated with higher a proportion of psychiatric comorbidity (IGE, 22.6%; controls, 13.0%) ( P < 0.001). Seizure‐free patients did not differ from controls; patients with persistent seizures had lower incomes and employment rates. In the IGE subgroup analyses, JME was associated with worse social status in all parameters studied (eg, 65.9% of JME patients were outside the workforce vs 44.5% of matched controls; P < 0.001), whereas no adverse social status was identified in patients with EGTCS and JAE. Significance Patients with IGE in general and JME in particular have poorer social status and more psychiatric comorbidity than matched population controls without epilepsy. Poor seizure control was associated with social status and may contribute to negative socioeconomic consequences associated with IGE.