Epileptic Seizures Psychological Factors and Occupational Adjustment

Abstract

SUMMARY One hundred nineteen epileptic former inpatients of the Boston Veterans Administration Hospital were interviewed and tested to evaluate their vocational adjustment since the onset of their seizures. The sample was restricted to males between 20 and 50 who had some adult work experience before developing seizures, and who had the onset of epilepsy more than three years prior to interview. The study excluded patients who had significant physical handicaps in addition to epilepsy, as well as those who had been treated for psychiatric disorders. Patients were classified as to severity of their seizure pattern, by means of a Work Suitability Scale. Personality and social history factors related to work adjustment were studied by means of a projective Sentence Completion test, an intelligence test, and a structured interview. Occupational adjustment in the two years preceding the first seizure was compared to that in the two years just prior to the interview. Ratings were based on the steadiness of employment, on the proportion of full‐time pay earned, on the frequency of job changes, and on the socio‐economic level of the occupation. The overall employment rate of 82% subdivides into a small group of 24 severe epileptics with a 50% employment rate and a larger balance of 95 subjects whose employment rate is 89%. The latter group, in turn, was made up of four levels of severity, according to the Work Suitability Scale. The most severe of these groups (52 patients) showed almost 50% decline in one or more of the indices of occupational adjustment i.e., steadiness, job changes, occupational level. The three mildest groups are uniform in their low (9%) unemployment rate and proportion of decline in occupational adjustment. The failure of the Sentence Completion test to discriminate those who adapted successfully is attributed to the restricted range of emotional disorders included in the sample. The 16 severe alcoholics in the study numbered among the most severe epileptics and accounted for one third of the totally unemployed. Premorbid training was also an important factor in the occupational prognosis, in that 37% of those who had unskilled occupations prior to seizures had been completely unemployed for the two years preceding their interview. Examining the circumstances under which the most severe epileptics continued to work revealed the existence of special sheltering conditions in every case. Of four who were unemployed, in spite of minimal seizures, all showed marked passive dependent traits and an accepting family setting. It is suggested that the group of epileptics having more than one grand mal seizure a month, without other complications, can profit the most from placement services. The cultivation of suitable job resources for this group is recommended. RÉSUMÉ 119 Épileptiques préalablement hospitalisés au “Boston Veterans Administration Hospital” ont été interviewés et soumis à des tests dans le but d'évaluer leur capacité de travail et son évolution depuis le début des crises. II convient de préci...

Social Adjustment and Competence 35 Years After Onset of Childhood Epilepsy: A Prospective Controlled Study

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Program Evaluation in Epilepsy Rehabilitation

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Comparison of the Psychosocial Effects of Epilepsy and Narcolepsy/Cataplexy: A Controlled Study

“…There are reports on public attitudes (Caveness et al, 1969;Caveness and Gallup, 1980) and social prejudice (Bagley, 1972), overall life performance (Rodin et al, 1977), and socioeconomic consequences (Wilson et al, 1960). The occupational difficulties have been discussed in articles on employability (Dennerll et al, 1966;Schwartz and Dennerll, 1967;Whitty, 1968;Frank, 1969), employer attitudes (Sands and Zalkind, 1972), work adjustment (Lennox and Mohr, 1950;Goodglass et al, 1963), and actual job performance (Udel, 1960;Sorel, 1972). Driving records in epileptic persons have been carefully analysed (Hormio, 1961 ;Waller, 1965;Millengen, 1976) and have led to licencing regulations.…”