AUTHOR=Arai Yuto , Okanishi Tohru , Noma Hisashi , Kanai Sotaro , Kawaguchi Tatsuya , Sunada Hiroshi , Fujimoto Ayataka , Maegaki Yoshihiro 

TITLE=Prognostic factors for employment outcomes in patients with a history of childhood-onset drug-resistant epilepsy

JOURNAL=Frontiers in Pediatrics

VOLUME=11

YEAR=2023

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2023.1173126

DOI=10.3389/fped.2023.1173126

ISSN=2296-2360

ABSTRACT=<sec><title>Objective</title><p>The employment outcomes of childhood-onset drug-resistant epilepsy (DRE) has not been studied enough. The aim of this retrospective cohort study is to investigate the employment outcomes of childhood-onset DRE in June 2022 and identify the risk factors associated with non-employment.</p></sec><sec><title>Materials and methods</title><p>The sample consisted of 65 participants ≥18 years of age with a history of childhood-onset DRE. Fifty participants (77%) were salaried employees and 15 participants (23%) were non-employed. Clinical and psychosocial information were evaluated for calculating the relative risk (RR) of non-employment.</p></sec><sec><title>Results</title><p>Regarding medical factors, lower IQ [RR, 0.645; 95% confidence interval (CI), 0.443–0.938; <italic>p </italic>= 0.022] was positively associated with employment. In contrast, age at follow-up (RR, 1.046; 95% CI, 1.009–1.085; <italic>p </italic>= 0.014); number of ASMs at follow-up (RR, 1.517; 95% CI, 1.081–2.129; <italic>p </italic>= 0.016); use of medications such as phenobarbital (RR, 3.111; 95% CI, 1.383–6.997; <italic>p </italic>= 0.006), levetiracetam (RR, 2.471; 95% CI, 1.056–5.782; <italic>p </italic>= 0.037), and topiramate (RR, 3.576; 95% CI, 1.644–7.780; <italic>p </italic>= 0.001) were negatively associated with employment. Regarding psychosocial factor, initial workplace at employment support facilities (RR, 0.241; 95% CI, 0.113–0.513; <italic>p</italic> &lt; 0.001) was positively associated with employment. In contrast, complication of psychiatric disorder symptoms (RR, 6.833; 95% CI, 2.141–21.810; <italic>p</italic> = 0.001) was negatively associated with employment. Regarding educational factor, graduating schools of special needs education (RR, 0.148; 95% CI, 0.061–0.360; <italic>p</italic> &lt; 0.001) was positively associated with employment.</p></sec><sec><title>Conclusions</title><p>Specific medical, psychosocial, and educational factors may influence the employment outcomes of childhood-onset DRE. Paying attention to ASMs’ side effects, adequately preventing the complications of psychiatric disorder symptoms, and providing an environment suitable for each patient condition would promote a fine working status for people with childhood-onset DRE.</p></sec>