Clinical factors associated with work disability in epilepsy: A cross-sectional study at a tertiary referral hospital

Objective: The impact of epilepsy on work disability remains unclear. The aim of this study was to deter-mine the percentage of patients with epilepsy who are unemployed or on temporary or permanent dis-ability leave and to analyze associated clinical factors. Methods: We performed an observational cross-sectional study of consecutively recruited patients with epilepsy seen at a specialized epilepsy unit or admitted to the epilepsy monitoring unit of a tertiary refer-ral hospital. We analyzed the percentage of patients who were actively employed, unemployed, and on temporary or permanent disability leave. The groups were compared for sociodemographic data (age, sex, marital status, and type of work), clinical data (type of epilepsy, disease duration, monthly seizure frequency, and presence of anxiety or depression), treatment-related factors, and quality of life. Results: We included 742 patients (53% male, mean age 44.3 +/- 13.7 years old): 40.5% were employed, 29.2% were unemployed, 19% were on temporary disability leave, and 11.1% had a permanent work dis-ability. Depressive symptoms and poorer quality of life were associated with unemployment (OR 2.3, p = 0.02 and OR 1.8, p = 0.01), temporary disability leave (OR 1.4, p = 0.05 and OR 1.7, p = 0.02), and per-manent work disability (OR 1.9, p = 0.01 and OR 2.2, p = 0.01). Low-skilled work was also predictive of unemployment (OR 1.9, p = 0.04), temporary disability leave (OR 2.8, p = 0.03), and permanent work dis-ability (OR 1.7, p = 0.04). A higher monthly seizure frequency was associated with permanent work dis-ability (OR 2.01, p = 0.02). Conclusion: Less than 50% of patients with epilepsy in our setting are working. Factors associated with unemployment and work disability are a higher frequency of seizures, low-skilled work, depressive symptoms, and poor quality of life. (c) 2021 Elsevier Inc. All rights reserved.