Psychosocial outcome of young adults with epilepsy in childhood.

Abstract

Objective-To evaluate social maturation and psychiatric morbidity in young adults treated for epilepsy during their childhood. Methods-Eighty one young adults (43 women, 38 men, mean age 22-3 years) with epilepsy during their childhood were interviewed about their social development and psychiatric symptoms. The results were compared with those from 211 randomly selected controls (106 women, 105 men, mean age 23-2 years). Results-Compared with the controls the patients had more often not succeeded in passing the normal comprehensive school (20% v 2%) or had left school at the secondary level (53% v 46%) and remained without any vocational education (27% v 11 %). There was no significant difference in the employment status of those with work between the patients and the controls. The patients were significantly more often labelled with poor social maturation and dependent lifestyle factors such as living with their parents. However, risk analysis showed that neither the disease itself nor antiepileptic medication were significant predisposing factors for poor social adjustment but low or borderline mental capacity or learning disabilities relating to epilepsy were. Psychiatric morbidity was similar in both groups. Conclusions-The social handicap found in a certain group of young adults with epilepsy during childhood is largely associated with neurological and cognitive impairments other than epilepsy itself. With the present mode of treatment epilepsy itself does not seem to disturb adolescent social and psychological development.

Behavior and social competency in idiopathic and cryptogenic childhood epilepsy

“…Comparisons were also made with sibling controls, thus greatly reducing potential confounding influences of familial and environmental factors. With these factors in mind, our finding of higher levels of behavioral problems in children who are seizure-free and off medication relative to their sibling control provides further evidence regarding the concerns raised in long-term follow-up studies of newly-diagnosed epilepsy, [12][13][14]21,22 that there are essential comorbidities associated with epilepsy itself that have an impact on the individual independent of seizures and medication.…”

“…Because these recent studies have not yet followed participants into adulthood, it is unclear how persistent these early indications of difficulties are, and whether these difficulties identified at initial diagnosis explain the unexpectedly poor outcomes in adults with childhood epilepsy in remission and no longer under treatment. [12][13][14]21,22 For example, one study reported that problems present at initial diagnosis did not persist a year later. 28 Our assessments were performed in the context of a large prospective community-based study.…”

“…On the other hand, several studies have examined social, educational, and employment outcomes in adults who, years previously as children, had epilepsy. [12][13][14]21,22 These studies focused on individuals with intelligence levels comparable to the population norm and either idiopathic or cryptogenic epilepsy. Many were completely seizure-free and off medication.…”

Clinical and neuropsychological assessment of executive function in a sample of children and adolescents with idiopathic epilepsy

“…Several epilepsy variables seem to impact on cognition, behavior and academic skills, including age of onset, disease duration, seizure severity, seizure type and antiepileptic drugs 2 . Also, genetic and environmental influences the degree of cognitive impairment, academic, behavioral and social performance in individuals with epilepsy 3,4,5,6 . Executive functions (EF) are a set of cognitive skills that enable the individual performance of voluntary actions to orient goals 7 , encompassing control processes in cognitive, emotional and social areas 8 .…”

Long‐term social outcomes for children with epilepsy

“…Oulu Finland (Kokkonen et al, 1997) This population-based Finnish series began as a prevalence cohort of all noninstitutionalized children with epilepsy (n = 92) born between 1964-67. When these patients were 22 years of age, they were compared with 211 controls from same birth cohort by interview or questionnaire.…”