Neurological and Psychological Factors related to Employability of Persons with Epilepsy

Abstract

SUMMARY An interdisciplinary research project was initiated for systematic, long‐term study of employability prognosis of persons with epilepsy. Neurological, psychological, and occupational status variables were investigated in three groups of epileptics: Employed adults, Unemployed adults, and a Prevocational Group of young persons primarily in the 11th and 12th grades. Preliminary results reported showed significant differences between Unemployed and Employed adult epileptics on a substantial number of measures that relate to employability suggesting a continuum of employability from very poor employability prognosis to very good prognosis. Based on the findings presented here, social adaptive abilities appear to be as important as seizure control, and perhaps even more important in the final outcome. In the meantime, increasing evidence does not provide support for the belief that drug therapy and changing employers' attitudes represent a sufficient attack on the employment problems of persons with epilepsy. RÉASUMÉA Un projet de recherche groupant plusieurs disciplines a eAteA mis sur pied. Elle avait pour but d'eAtudier, d'une facLon systeAmatique et sur une longue peAriode, le pronostic de l'emploi d'individus souffrant d'eApilepsie. Plusieurs variables furent exploreAes: neurologique, psychologique et occupationnelle. Trois groupes d'eApileptiques furent examineAs: (1) adultes posseAdant un emploi; (2) adultes sans emploi; (3) jeunes individus en majoriteA dans leur 11e ou 12e anneAe de scolariteA (groupe preA‐vocationnel). Les premiers reAsultats deAmontrent qu'il y existe une diffeArence significative entre le groupe des adultes sans emploi et celui des adultes ayant un emploi. De nombreuses mesures portant sur les possibiliteAs d'emploi mirent aG jour ces diffeArences et suggeAreGrent un continuum dans les possibiliteAs d'emploi qui variait d'un pronostic treGs pauvre aG treGs bon. D'apreGs les reAsultats obtenus, les capaciteAs d'adaptation sociale semblent eCtre importantes en tant que meAcanisme de controCle des crises et elles sont possiblement encore plus importantes en ce qui concerne l'issue finale. En attendant, il est de plus en plus eAvident que le traitement meAdicamenteux et le changement d'attitude des employeurs ne s'attaquent pas d'une manieGre suffisante aux probleGmes de l'emploi d'individus souffrant d'eApilepsie.

Occupational adjustment following neurosurgical treatment of epilepsy

“…The postoperatively employed patients showed a much lower mean duration of unemployment during the 5 years prior to operation (mean, 0.73 years) than did the postoperatively unemployed, who averaged 4.0 years of unemployment Cp < 0.01). The differences are consistent with the findings of Dennerll and colleagues [5].…”

Psychoses in drug-resistant temporal lobe epilepsy.

“…As epilepsy begins later in psychotics (Scott, 1978), they have the chance of more advanced education which seems to benefit them little, as fewer find employment than their less well-endowed nonpsychotic fellow epileptics, despite control of their epilepsy. At follow-up significantly fewer psychotics were in full-time employment compared with nonpsychotics, as reported earlier by Juul-Jensen (1964), Dennerl et al (1966 and Rodin (1968).…”

Employability in people with epilepsy: A systematic review

“…of sick leaves (Lassouw et al, 1997) Vocational training (Lassouw et al, 1997) Injury frequency during seizure attack (Dennerll et al, 1966) Others: Seizure diagnosis (Herodes et al, 2001;Sillanpaa et al, 1998;Wheless, 2006) Seizure severity (De Boer, 2005;Lim et al, 2013c) Epilepsy Type (Lim et al, 2013c;Pal et al, 2008) Age of surgery epilepsy (George et al, 2009;Zarroli et al, 2011) Having partial seizure history (Jacoby et al, 2005) Seizure epilepticus (Sillanpaa and Schmidt, 2010) Responsiveness to AED (Lim et al, 2013c) Side effect of AED (Wheless, 2006) Medicine compliance (Chen et al, 2010) Approval of LEV (Korchounov et al, 2012) History of psychotic test (Wada et al, 2001) Post ATL follow-up duration (George et al, 2009) Others: Types of antiepileptic drug (Haag et al, 2010) Use of antiepileptic drugs (Jacoby et al, 2005) History of Convulsion (Bautista and Wludyka, 2007) History of GTC in last year (Lee, 2005) Side effect of AED (Bautista and Wludyka, 2007) Side of lesion (Bautista and Wludyka, 2007;Zarroli et al, 2011) Timing of seizure attack (Elwes et al, 1991;Lee, 2005;The RESt-1 Group, 2000) Others:…”