title: An investigation into the psychosocial effects of the postictal state.
abstract: OBJECTIVE
  To determine whether postictal cognitive and behavioral impairment (PCBI) is independently associated with specific aspects of a patient's psychosocial health in those with epilepsy and nonepileptic events.
  
  
  METHODS
  We used the University of Calgary's Comprehensive Epilepsy Clinic prospective cohort database to identify patients reporting PCBI. The cohort was stratified into those diagnosed with epilepsy or nonepileptic events at first clinic visit. Univariate comparisons and stepwise multiple logistic regression with backward elimination method were used to identify factors associated with PCBI for individuals with epilepsy and those with nonepileptic events. We then determined if PCBI was independently associated with depression and the use of social assistance when controlling for known risk factors.
  
  
  RESULTS
  We identified 1,776 patients, of whom 1,510 (85%) had epilepsy and 235 had nonepileptic events (13%). PCBI was independently associated with depression in those with epilepsy (odds ratio [OR] 1.73; 95% confidence interval [CI] 1.06-2.83; p = 0.03) and with the need for social assistance in those with nonepileptic events (OR 4.81; 95% CI 2.02-11.42; p < 0.001).
  
  
  CONCLUSIONS
  PCBI appears to be significantly associated with differing psychosocial outcomes depending on the patient's initial diagnosis. Although additional research is necessary to examine causality, our results suggest that depression and employment concerns appear to be particularly important factors for patients with PCBI and epilepsy and nonepileptic attacks, respectively.
authors.affiliation: From the Department of Clinical Neurosciences (C.B.J., N.J., Y.A.-K., P.F., W.M., N.P., S.W.), Clinical Research Unit (J.D.T.E., T.T.S., S.W.), and Department of Community Health Sciences (T.T.S., N.J., S.W.), Cumming School of Medicine, Hotchkiss Brain Institute (T.T.S., N.J., P.F., S.W.), and O'Brien Institute of Public Health (T.T.S., N.J., S.W.), University of Calgary, Canada.
authors.forename: Colin B
authors.initials: CB
authors.lastname: Josephson
authors.affiliation: From the Department of Clinical Neurosciences (C.B.J., N.J., Y.A.-K., P.F., W.M., N.P., S.W.), Clinical Research Unit (J.D.T.E., T.T.S., S.W.), and Department of Community Health Sciences (T.T.S., N.J., S.W.), Cumming School of Medicine, Hotchkiss Brain Institute (T.T.S., N.J., P.F., S.W.), and O'Brien Institute of Public Health (T.T.S., N.J., S.W.), University of Calgary, Canada.
authors.forename: Jordan D T
authors.initials: JD
authors.lastname: Engbers
authors.affiliation: From the Department of Clinical Neurosciences (C.B.J., N.J., Y.A.-K., P.F., W.M., N.P., S.W.), Clinical Research Unit (J.D.T.E., T.T.S., S.W.), and Department of Community Health Sciences (T.T.S., N.J., S.W.), Cumming School of Medicine, Hotchkiss Brain Institute (T.T.S., N.J., P.F., S.W.), and O'Brien Institute of Public Health (T.T.S., N.J., S.W.), University of Calgary, Canada.
authors.forename: Tolulope T
authors.initials: TT
authors.lastname: Sajobi
authors.affiliation: From the Department of Clinical Neurosciences (C.B.J., N.J., Y.A.-K., P.F., W.M., N.P., S.W.), Clinical Research Unit (J.D.T.E., T.T.S., S.W.), and Department of Community Health Sciences (T.T.S., N.J., S.W.), Cumming School of Medicine, Hotchkiss Brain Institute (T.T.S., N.J., P.F., S.W.), and O'Brien Institute of Public Health (T.T.S., N.J., S.W.), University of Calgary, Canada.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Jette
authors.affiliation: From the Department of Clinical Neurosciences (C.B.J., N.J., Y.A.-K., P.F., W.M., N.P., S.W.), Clinical Research Unit (J.D.T.E., T.T.S., S.W.), and Department of Community Health Sciences (T.T.S., N.J., S.W.), Cumming School of Medicine, Hotchkiss Brain Institute (T.T.S., N.J., P.F., S.W.), and O'Brien Institute of Public Health (T.T.S., N.J., S.W.), University of Calgary, Canada.
authors.forename: Yahya
authors.initials: Y
authors.lastname: Agha-Khani
authors.affiliation: From the Department of Clinical Neurosciences (C.B.J., N.J., Y.A.-K., P.F., W.M., N.P., S.W.), Clinical Research Unit (J.D.T.E., T.T.S., S.W.), and Department of Community Health Sciences (T.T.S., N.J., S.W.), Cumming School of Medicine, Hotchkiss Brain Institute (T.T.S., N.J., P.F., S.W.), and O'Brien Institute of Public Health (T.T.S., N.J., S.W.), University of Calgary, Canada.
authors.forename: Paolo
authors.initials: P
authors.lastname: Federico
authors.affiliation: From the Department of Clinical Neurosciences (C.B.J., N.J., Y.A.-K., P.F., W.M., N.P., S.W.), Clinical Research Unit (J.D.T.E., T.T.S., S.W.), and Department of Community Health Sciences (T.T.S., N.J., S.W.), Cumming School of Medicine, Hotchkiss Brain Institute (T.T.S., N.J., P.F., S.W.), and O'Brien Institute of Public Health (T.T.S., N.J., S.W.), University of Calgary, Canada.
authors.forename: William
authors.initials: W
authors.lastname: Murphy
authors.affiliation: From the Department of Clinical Neurosciences (C.B.J., N.J., Y.A.-K., P.F., W.M., N.P., S.W.), Clinical Research Unit (J.D.T.E., T.T.S., S.W.), and Department of Community Health Sciences (T.T.S., N.J., S.W.), Cumming School of Medicine, Hotchkiss Brain Institute (T.T.S., N.J., P.F., S.W.), and O'Brien Institute of Public Health (T.T.S., N.J., S.W.), University of Calgary, Canada.
authors.forename: Neelan
authors.initials: N
authors.lastname: Pillay
authors.affiliation: From the Department of Clinical Neurosciences (C.B.J., N.J., Y.A.-K., P.F., W.M., N.P., S.W.), Clinical Research Unit (J.D.T.E., T.T.S., S.W.), and Department of Community Health Sciences (T.T.S., N.J., S.W.), Cumming School of Medicine, Hotchkiss Brain Institute (T.T.S., N.J., P.F., S.W.), and O'Brien Institute of Public Health (T.T.S., N.J., S.W.), University of Calgary, Canada. swiebe@ucalgary.ca.
authors.forename: Samuel
authors.initials: S
authors.lastname: Wiebe
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D004827:Epilepsy / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011584:Psychology; D012919:Social Behavior; D012944:Social Support; D055815:Young Adult
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