Functioning and Disability in Person with Epilepsy: Evaluating Need Rehabilitation with ICF

Leonardi, Matilde; Ajovalasit, Daniela; Albanesi, Francesca; Černiauskaitė, Milda; Invernizzi, Veronica; Quintas, Rui; Sattin, Davide; Franceschetti, Silvana; Casazza, Marina

doi:10.1097/00004356-200908001-00066

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“…The WHODAS has a thirteenth question to indicate "How much do these difficulties [any endorsed] interfere with your life?". The WHODAS 12-item assessment tool has been shown to be valid and reliable in rating disability [23], and has been used among people with epilepsy [24][25][26][27][28][29][30].…”

Section: Methodsmentioning

confidence: 99%

Disability patterns over the first year after a diagnosis of epilepsy

Neuen

Glozier

et al. 2019

Clinical Neurology and Neurosurgery

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2019) Disability patterns over the first year after a diagnosis of epilespy. Clinical Neurology and Neurosurgery, 179,[60][61][62][63][64][65] Objective: To determine the patterns and predictors of disability over the first 12 months after a diagnosis of epilepsy. Patients and methods: The Sydney Epilepsy Incidence Study to Measure Illness Consequences (SEISMIC) was a prospective, multicenter, community-based study of people with newly diagnosed epilepsy in Sydney, Australia. Disability was assessed using the World Health Organization's, Disability Assessment Schedule (WHODAS) 2.0 12-item version, at baseline (i.e. within 28 days of diagnosis) and 12 months post-diagnosis. Demographic, socioeconomic, clinical and epilepsy-related data, obtained through structured interviews, were entered into multivariable linear regression and shift analysis to determine predictors of greater disability. Results: Of 259 adults (≥18 years), 190 (73%) had complete WHODAS at baseline (mean ± SD scores 4 ± 6) and follow-up (4 ± 8). After adjustment for age, sex and co-morbidity, greater overall disability at 12 months was associated with lower education (P = 0.05), economic hardship (P = 0.004), multiple antiepileptic medications (P = 0.02) and greater disability (P < 0.001) at the time of diagnosis; these variables explained 38.3% of the variance. Among the 12 WHODAS items, "being emotionally affected by health problems" was the most frequent disability problem identified at both time points (all P < 0.0001). The proportion of participants without problems in that domain improved over 12 months (from 24% to 50%, P < 0.0001), whereas the other 11 items remained relatively stable. Independent baseline predictors of a worse emotional outcome at 12 months were severe/extreme emotional distress (odds ratio [OR] 4.52, 95% confidence intervals [CI] 1.67-12.24), economic hardship (OR 2.30, 95% CI 1.24-4.25) and perceived stigma (OR 2.02, 95% CI 1.03-3.93). Conclusion: Most people report problems with emotional health after a diagnosis of epilepsy but many recover over the next 12 months. Services addressing the social and psychological impact of diagnosis may be needed to improve outcome.

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