SOCIAL-ADJUSTMENT AND COMPETENCE 35 YEARS AFTER ONSET OF CHILDHOOD EPILEPSY - A PROSPECTIVE CONTROLLED-STUDY

Purpose: To study the effect of childhood-onset epilepsy without other neurologic deficit on adult social adjustment and competence. Methods : Social competence was studied in a prospective, population-based coh ort of childhood-onset epilepsy after a mean follow-up of 35 years. On e hundred patients (60% of the total cohort) had no other neurologic p roblems (''epilepsy only''), and for each patient, two matched control s, a ''random'' control and an ''employee'' control were chosen. Resul ts: Good social outcome was significantly reduced in the ''epilepsy on ly'' cohort compared with random controls: education [cumulative odds ratio (COR), 2.4; 95% confidence interval (CI), 1.4-4.1]; employabilit y (COR, 7.3; 95% CI, 2.7-20.0); and marriage rate (COR, 3.7; 95% CI, 1 .9-7.3). The patients with epilepsy rated their own ability to control their lives as ''poor or missing'' four times more frequently than th e employee controls. Patients receiving antiepileptic polytherapy, but not monotherapy, were significantly less satisfied with their present life (OR, 6.7; 95% CI, 1.9-24.1) and felt their general health was si gnificantly poorer (OR, 5.1; 95% CI, 1.2-21.3) than did the employee c ontrols. Furthermore, patients with continuing seizures were significa ntly less satisfied with their present life (OR, 4.1; 95% CI, 1.1-15.1 ) than were employee controls. Conclusions: Many patients with ''epile psy only'' beginning in childhood have persistent and significant soci al-adjustment and competence problems in adulthood.