Department of Neurology, Odense University Hospital, Odense, Denmark.
National Center for Register-Based Research, Aarhus University, Aarhus, Denmark.
Epilepsia. 2021 May;62(5):1158-1169. doi: 10.1111/epi.16870. Epub 2021 Mar 18.
To investigate social outcome and psychiatric comorbidity of patients with idiopathic/genetic generalized epilepsies (IGEs) and its subtypes (epilepsy with generalized tonic-clonic seizures alone [EGTCS], juvenile absence epilepsy [JAE], and juvenile myoclonic epilepsy [JME]).
A cohort of 402 adult patients with IGE from the Danish island Funen was matched with 4020 randomly selected geography-, age-, and sex-matched controls via the Danish Civil Registration System. Based on register data, we compared social status measured by cohabitant status, educational attainment, income, affiliation to labor market, and psychiatric comorbidity.
As compared to controls, patients with IGE had similar cohabitant status but fewer children (no children: 59.0% vs 50.9%), and lower educational level (primary school only: 46.0% vs 37.3%), employment rate (outside of workforce: 56.7% vs 46.5%), and income (low income: 32.6% vs 24.9%) (P < 0.001 for all comparisons). Having IGE was associated with higher a proportion of psychiatric comorbidity (IGE, 22.6%; controls, 13.0%) (P < 0.001). Seizure-free patients did not differ from controls; patients with persistent seizures had lower incomes and employment rates. In the IGE subgroup analyses, JME was associated with worse social status in all parameters studied (eg, 65.9% of JME patients were outside the workforce vs 44.5% of matched controls; P < 0.001), whereas no adverse social status was identified in patients with EGTCS and JAE.
Patients with IGE in general and JME in particular have poorer social status and more psychiatric comorbidity than matched population controls without epilepsy. Poor seizure control was associated with social status and may contribute to negative socioeconomic consequences associated with IGE.
研究特发性/遗传性全面性癫痫（IGE）及其亚型（单纯全身强直-阵挛发作性癫痫[EGTCS]、青少年失神癫痫[JAE]和青少年肌阵挛性癫痫[JME]）患者的社会结局和精神共病情况。
通过丹麦民事登记系统，对来自丹麦菲英岛的 402 名成年 IGE 患者进行了队列研究，并与 4020 名随机选择的地理、年龄和性别匹配的对照进行了匹配。基于登记数据，我们比较了通过同居状况、教育程度、收入、劳动市场参与度和精神共病情况来衡量的社会地位。
与对照组相比，IGE 患者的同居状况相似，但子女较少（无子女：59.0%比 50.9%），教育程度较低（仅小学：46.0%比 37.3%），就业率较低（不在劳动力市场：56.7%比 46.5%），收入较低（低收入：32.6%比 24.9%）（所有比较均 P<0.001）。患有 IGE 与更高比例的精神共病相关（IGE：22.6%；对照组：13.0%）（P<0.001）。无发作的患者与对照组无差异；持续性发作的患者收入和就业率较低。在 IGE 亚组分析中，JME 在所有研究参数中均与较差的社会地位相关（例如，JME 患者中有 65.9%不在劳动力市场，而匹配对照组中只有 44.5%；P<0.001），而 EGTCS 和 JAE 患者则没有发现不良的社会地位。
一般来说，IGE 患者，特别是 JME 患者，与无癫痫的匹配人群对照组相比，社会地位较差，精神共病较多。癫痫控制不佳与社会地位相关，可能导致与 IGE 相关的负面社会经济后果。
