Social adjustment and competence 35 years after onset of childhood epilepsy: a prospective controlled study.
OBJECTIVE
To study the effect of childhood-onset epilepsy without other neurologic deficit on adult social adjustment and competence.


METHODS
Social competence was studied in a prospective, population-based cohort of childhood-onset epilepsy after a mean follow-up of 35 years. One hundred patients (60% of the total cohort) had no other neurologic problems ("epilepsy only"), and for each patient, two matched controls, a "random" control and an "employee" control were chosen.


RESULTS
Good social outcome was significantly reduced in the "epilepsy only" cohort compared with random controls: education [cumulative odds ratio (COR), 2.4; 95% confidence interval (CI), 1.4-4.1]; employability (COR, 7.3; 95% CI, 2.7-20.0); and marriage rate (COR, 3.7; 95% CI, 1.9-7.3). The patients with epilepsy rated their own ability to control their lives as "poor or missing" four times more frequently than the employee controls. Patients receiving antiepileptic polytherapy, but not monotherapy, were significantly less satisfied with their present life (OR, 6.7; 95% CI, 1.9-24.1) and felt their general health was significantly poorer (OR, 5.1; 95% CI, 1.2-21.3) than did the employee controls. Furthermore, patients with continuing seizures were significantly less satisfied with their present life (OR, 4.1; 95% CI, 1.1-15.1) than were employee controls.


CONCLUSIONS
Many patients with "epilepsy only" beginning in childhood have persistent and significant social-adjustment and competence problems in adulthood.
Jalava
M
M
Department of Child Neurology, University of Turku, Finland.
Sillanpää
M
M
Camfield
C
C
Camfield
P
P
D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D000704:Analysis of Variance; D000927:Anticonvulsants / Q000627:therapeutic use; D001294:Attitude to Health; D002648:Child; D004359:Drug Therapy, Combination; D004522:Educational Status; D004651:Employment; D004827:Epilepsy / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D017533:Marital Status; D010549:Personal Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D012917:Social Adjustment
D000927:Anticonvulsants