Danish Center for Sleep Medicine, Department of Clinical +Neurophysiology, Faculty of Health Sciences, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark.
Department of Paediatrics, Herlev University Hospital, Copenhagen, Denmark.
Epilepsy Behav. 2021 Jan;114(Pt A):107256. doi: 10.1016/j.yebeh.2020.107256. Epub 2020 Jul 1.
Childhood- and adolescent-onset epilepsy may have a significant impact on long-term educational and vocational status, which in turn has consequences for individuals' socioeconomic status. We estimated the factual long-term socioeconomic consequences and healthcare costs of individuals with diagnosed epilepsy.
The prospective cohort study included Danish individuals with epilepsy onset before the age of 18 years, diagnosed between 2002 and 2016. Healthcare costs and socioeconomic data were obtained from nationwide administrative and health registers. The prediction was made with a general estimating equation (GEE). A total of 15,329 individuals were found with the diagnosis during this period and were followed until the age of 30 years. These were compared with 31,414 controls. We used 30 years as this represent an age where most has finalized their education, and as such represent the final educational level. Patients and their controls were subdivided into debut age groups of 0-5 and 6-18 years. Individuals were matched for age, gender, and residential location.
Compared with control groups, patients with epilepsy at the age of 30 years tended to have the following: 1) parents with lower educational attainment; 2) a significantly lower educational level when controlling for parental education attainment; 3) lower grade-point averages; 4) a lower probability of being in employment and lower income, even when transfer payments were considered; and 5) elevated healthcare costs, including those for psychiatric care. It was also noted that the long-term educational consequences for patients with epilepsy were associated with parental educational level. Differences were more pronounced for those with early (0-5 years) rather than later (6-18 years) onset epilepsy.
Epilepsy is associated with severe long-term socioeconomic consequences: lower educational level, school grades, employment status, and earned income. The presence of epilepsy is associated with parental educational level.
SIGNIFICANT OUTCOMES.
儿童期和青少年期起病的癫痫可能对长期的教育和职业状况产生重大影响，进而影响个体的社会经济地位。我们评估了确诊癫痫患者的实际长期社会经济后果和医疗保健费用。
这项前瞻性队列研究纳入了 2002 年至 2016 年期间诊断为 18 岁以下起病癫痫的丹麦个体。医疗保健费用和社会经济数据来自全国性的行政和健康登记处。使用广义估计方程（GEE）进行预测。在此期间，共发现 15329 例患者患有该疾病，并随访至 30 岁。将他们与 31414 名对照进行比较。我们选择 30 岁作为研究终点，因为大多数人在此年龄段已经完成了学业，这也是最终的教育水平。将患者及其对照按发病年龄 0-5 岁和 6-18 岁进行分组。对个体进行年龄、性别和居住地点匹配。
与对照组相比，30 岁时患有癫痫的个体：1）其父母的受教育程度较低；2）在控制父母受教育程度的情况下，教育水平显著较低；3）平均绩点较低；4）在考虑转移支付的情况下，就业和收入较低的可能性较大；5）医疗保健费用增加，包括精神科护理费用。还注意到，癫痫患者的长期教育后果与父母的教育水平相关。对于发病年龄较早（0-5 岁）的患者，其差异比发病年龄较晚（6-18 岁）的患者更明显。
癫痫与严重的长期社会经济后果相关，包括教育水平较低、学业成绩较差、就业状况不佳和收入较低。癫痫的存在与父母的教育水平相关。
本研究存在重要的局限性。
