title: Risk factors for early disability pension in patients with epilepsy and vocational difficulties - Data from a specialized rehabilitation unit.
abstract: OBJECTIVE
  The purpose of this study was to assess the risk factors for early disability pension (EDP) in adult patients with epilepsy in a specialized epilepsy rehabilitation setting.
  
  
  METHODS
  In a retrospective study, 246 patients with epilepsy and employment difficulties leading to referral to an inpatient rehabilitation unit were evaluated with a questionnaire on admission and after a mean of 2.5years after discharge. Patients already receiving EDP at baseline were excluded. Epilepsy-related, demographic, and employment-related data as well as cognitive functioning and psychiatric comorbidity were assessed as risk factors for EDP at follow-up and analyzed using logistic regression models.
  
  
  RESULTS
  Seventy-six percent of the patients had uncontrolled epilepsy, and 66.7% had psychiatric comorbidity. At follow-up, 33.7% received an EDP. According to multivariate logistic regression analysis, age>50years (odds ratio (OR) 5.44, compared to age<30years), application for an EDP prior to admission (OR 3.7), sickness absence>3months in the previous year (OR 3.30, compared to sickness absence<3months), and psychiatric comorbidity (OR 2.79) were significant risk factors for an EDP at follow-up, while epilepsy-related factors and cognitive impairment showed an effect only in the univariate analyses.
  
  
  CONCLUSIONS
  Potential risk factors for EDP in patients with epilepsy were evaluated using multivariate analysis. Knowledge of such factors may help to develop appropriate criteria for rehabilitation candidacy and interventions to reduce the risk for EDP. This might lead to an amelioration of both psychosocial burden of patients and economic burden on society.
authors: Epilepsy Centre Bethel, Rehabilitation Unit, Mara Hospital, Maraweg 21, D-33617 Bielefeld, Germany. Electronic address: ulrich.specht@mara.de.
authors: Ulrich
authors: U
authors: Specht
authors: Epilepsy Centre Bethel, Rehabilitation Unit, Mara Hospital, Maraweg 21, D-33617 Bielefeld, Germany. Electronic address: ingrid.coban@mara.de.
authors: Ingrid
authors: I
authors: Coban
authors: Epilepsy Centre Bethel, Rehabilitation Unit, Mara Hospital, Maraweg 21, D-33617 Bielefeld, Germany; Epilepsy Centre Bethel, Society for Epilepsy Research, Maraweg 13, D-33617 Bielefeld, Germany. Electronic address: christian.bien@mara.de.
authors: Christian G
authors: CG
authors: Bien
authors: Epilepsy Centre Bethel, Society for Epilepsy Research, Maraweg 13, D-33617 Bielefeld, Germany. Electronic address: may_gfe@t-online.de.
authors: Theodor W
authors: TW
authors: May
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D003071:Cognition; D003072:Cognition Disorders / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D015897:Comorbidity; D017281:Cost of Illness; D004185:Disability Evaluation; D004651:Employment / Q000706:statistics & numerical data; D004827:Epilepsy / Q000191:economics* / Q000453:epidemiology* / Q000534:rehabilitation; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications; D008875:Middle Aged; D010415:Pensions / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D018582:Sick Leave / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Cognitive impairment; Psychiatric comorbidity; Sickness absence; Unemployment