title: The impact of seizures on epilepsy outcomes: A national, community-based survey.
abstract: The aim of this study was to examine the impact of seizures on persons living with epilepsy in a national, community-based setting.
  
  
  
  The data source was the Survey of Living with Neurological Conditions in Canada (SLNCC), a cohort derived from a national population-based survey of noninstitutionalized persons aged 15 or more years. Participants had to be on a seizure drug or to have had a seizure in the past 5 years to meet the definition of active epilepsy. The respondents were further stratified by seizure status: the seizure group experienced ≥1 seizure in the past 5 years versus the no seizure group who were seizure-free in the past ≥5 years regardless of medication status. Weighted overall and stratified prevalence estimates and odds ratios were used to estimate associations.
  
  
  
  The SLNCC included 713 persons with epilepsy with a mean age of 45.4 (standard deviation 18.0) years. Fewer people in the seizure group (42.7%) reported being much better than a year ago versus those in the no seizure group (70.1%). Of those with seizures, 32.1% (95% confidence interval [95% CI] 18.8-45.3) had symptoms suggestive of major depression (as per the Patient Health Questionnaire-9) compared to 7.7% (95% CI 3.4-11.9) of those without seizures. Driving, educational, and work opportunities were also significantly limited, whereas stigma was significantly greater in those with seizures.
  
  
  
  This community-based study emphasizes the need for seizure freedom to improve clinical and psychosocial outcomes in persons with epilepsy. Seizure freedom has an important influence on overall health, as those with at least one seizure over the prior 5 years had an increased risk of mood disorders, worse quality of life, and faced significantly more stigma.
authors.affiliation: Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.|Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.|Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.|O'Brien Institute of Public Health, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Colin B
authors.identifier: 0000-0001-7052-1651
authors.initials: CB
authors.lastname: Josephson
authors.affiliation: Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.|Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.|O'Brien Institute of Public Health, University of Calgary, Calgary, Alberta, Canada.|Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Scott B
authors.initials: SB
authors.lastname: Patten
authors.affiliation: Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.|Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.|O'Brien Institute of Public Health, University of Calgary, Calgary, Alberta, Canada.|Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada.|Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Andrew
authors.initials: A
authors.lastname: Bulloch
authors.affiliation: Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Jeanne V A
authors.initials: JVA
authors.lastname: Williams
authors.affiliation: Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Dina
authors.initials: D
authors.lastname: Lavorato
authors.affiliation: Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.|Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.|O'Brien Institute of Public Health, University of Calgary, Calgary, Alberta, Canada.|Department of Critical Care, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Kirsten M
authors.initials: KM
authors.lastname: Fiest
authors.affiliation: Canadian Epilepsy Alliance, London, Ontario, Canada.|Neurological Health Charities Canada, London, Ontario, Canada.
authors.forename: Mary
authors.initials: M
authors.lastname: Secco
authors.affiliation: Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.|Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.|Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.|O'Brien Institute of Public Health, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Jette
mesh_terms: D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use; D002170:Canada; D015331:Cohort Studies; D003865:Major Depressive Disorder / Q000453:epidemiology; D004827:Epilepsy / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D057187:Independent Living; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012917:Social Adjustment; D057545:Social Stigma; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000927:Anticonvulsants
keywords: Comorbidities; Epidemiology; Epilepsy; Population-based; Stigma