Predictors of high school dropout, anxiety, and depression in genetic generalized epilepsy.

Marte Syvertsen,Thea Moth,Ulla Enger,Samitha Vasantharajan,Jeanette Koht

doi:10.1002/epi4.12434

Abstract

Affective disorders are overrepresented in epilepsy, and people with epilepsy may be at risk of dropping out from school. The aim of the present study was to assess factors influencing high school dropout, anxiety, and depression in genetic generalized epilepsy (GGE). One hundred and ten people with GGE aged 19‐40 years underwent a clinical interview, including the Hospital Anxiety and Depression Scale (HADS) questionnaire. Potential predictors of high school dropout were analyzed with logistic regression, and factors influencing total HADS score were analyzed with linear regression. Having felt excluded because of epilepsy was significantly associated with high school dropout (odds ratio 7.80, P = .009), as was total HADS score (odds ratio 1.22, P = .005). If a participant was currently employed or undergoing education, previous high school dropout was less likely (odds ratio 0.07, P = .005). High school dropout was associated with increased current anxiety and depression (β = 0.32, P = .005). Epilepsy severity (current drug resistance, current polytherapy, and active generalized tonic‐clonic seizures) was not associated with high school dropout, nor with total HADS score. The issue of stigma in epilepsy must be thoroughly addressed in comprehensive care and may be as important as seizure control when it comes to education and quality of life.

Highlights

Epilepsy is one of the most common neurological disorders, affecting approximately 0.7% of the population in the Nordic countries.[1,2] People with epilepsy suffer from sudden and unpredictable seizures, and affective disorders are overrepresented, with a strong association to reduced quality of life.[3]Epileptic seizures may commence at any age, and nearly half of those affected are younger than 40 years.[4]
Female Mean age at inclusion (y) Mean epilepsy duration (y) Childhood absence epilepsy (CAE) Juvenile absence epilepsy (JAE) Juvenile myoclonic epilepsy (JME) Epilepsy with generalized tonic-clonic seizures only (EGTCS) Current polytherapy GTCS within the last year Current drug-resistant epilepsy Currently working or studying Felt excluded because of epilepsy Wished to keep diagnosis of epilepsy secret Troublesome conditions at home Use of mental health services Epilepsy influenced the choice of education and/or work Diagnosed with attention-deficit/hyperactivity disorder (ADHD) High school dropout Highest educational level
The variables significantly associated with high school dropout were current work or education, having felt excluded because of epilepsy, wishing to keep the diagnosis secret, and total Hospital Anxiety and Depression Scale (HADS) score, Table 2

Summary

Introduction

Epileptic seizures may commence at any age, and nearly half of those affected are younger than 40 years.[4] Adolescence is a vulnerable phase, when identity, acceptance, and belonging are major concerns. It is a phase involving important choices, like education and future work. The exact reasons for dropout are unclear, . They are important to identify, in order to develop targeted preventive strategies

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