Abstract
BACKGROUND: Few studies have measured, using validated scales, the psychosocial handicap of epilepsy in a general practice setting. AIM: To assess the prevalence of psychosocial problems associated with epilepsy. METHOD: A survey was undertaken of 309 subjects, with one or more non-febrile epileptic seizures, drawn from two general practices in the United Kingdom (UK). The outcome measures were the Subjective Handicap of Epilepsy Scale (SHE), the SF-36, and the Hospital Anxiety and Depression scale (HAD). RESULTS: One-third of persons with active epilepsy were significantly handicapped by their condition. The severity of subjective handicap was related to seizure frequency and to the duration of remission of seizures. Between one-third and one-half of subjects scored as 'cases' on the HAD scale and on the mental health subscale of the SF-36. Only one-third of the psychiatric morbidity revealed by the questionnaires had been recognized by the general practitioner (GP). Scores on the SF-36 indicated that people with active seizures perceived themselves as significantly less healthy than those in remission, and that, for persons in remission, drug treatment had a detrimental effect on certain aspects of well-being. CONCLUSIONS: The occurrence of seizures, even at low frequencies, is associated with psychosocial handicap, and this may remain covert in general practice.
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- Brown G. W., Craig T. K., Harris T. O. Depression: distress or disease? Some epidemiological considerations. Br J Psychiatry. 1985 Dec;147:612–622. doi: 10.1192/bjp.147.6.612. [DOI] [PubMed] [Google Scholar]
- Elwes R. D., Marshall J., Beattie A., Newman P. K. Epilepsy and employment. A community based survey in an area of high unemployment. J Neurol Neurosurg Psychiatry. 1991 Mar;54(3):200–203. doi: 10.1136/jnnp.54.3.200. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Finlay-Jones R. A., Burvill P. W. The prevalence of minor psychiatric morbidity in the community. Psychol Med. 1977 Aug;7(3):475–489. doi: 10.1017/s0033291700004463. [DOI] [PubMed] [Google Scholar]
- Freeling P., Rao B. M., Paykel E. S., Sireling L. I., Burton R. H. Unrecognised depression in general practice. Br Med J (Clin Res Ed) 1985 Jun 22;290(6485):1880–1883. [PMC free article] [PubMed] [Google Scholar]
- Goodridge D. M., Shorvon S. D. Epileptic seizures in a population of 6000. I: Demography, diagnosis and classification, and role of the hospital services. Br Med J (Clin Res Ed) 1983 Sep 3;287(6393):641–644. doi: 10.1136/bmj.287.6393.641. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hart Y. M., Shorvon S. D. The nature of epilepsy in the general population. I. Characteristics of patients receiving medication for epilepsy. Epilepsy Res. 1995 May;21(1):43–49. doi: 10.1016/0920-1211(95)00007-w. [DOI] [PubMed] [Google Scholar]
- Jacoby A., Baker G. A., Steen N., Potts P., Chadwick D. W. The clinical course of epilepsy and its psychosocial correlates: findings from a U.K. Community study. Epilepsia. 1996 Feb;37(2):148–161. doi: 10.1111/j.1528-1157.1996.tb00006.x. [DOI] [PubMed] [Google Scholar]
- Jenkinson C., Coulter A., Wright L. Short form 36 (SF36) health survey questionnaire: normative data for adults of working age. BMJ. 1993 May 29;306(6890):1437–1440. doi: 10.1136/bmj.306.6890.1437. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lewis G., Wessely S. Comparison of the General Health Questionnaire and the Hospital Anxiety and Depression Scale. Br J Psychiatry. 1990 Dec;157:860–864. doi: 10.1192/bjp.157.6.860. [DOI] [PubMed] [Google Scholar]
- O'Donoghue M. F., Duncan J. S., Sander J. W. The subjective handicap of epilepsy. A new approach to measuring treatment outcome. Brain. 1998 Feb;121(Pt 2):317–343. doi: 10.1093/brain/121.2.317. [DOI] [PubMed] [Google Scholar]
- Redhead K., Tasker P., Suchak K., Ahmed M., Copsey G., Roberts P., Daws J., Titmarsh M. Audit of the care of patients with epilepsy in general practice. Br J Gen Pract. 1996 Dec;46(413):731–734. [PMC free article] [PubMed] [Google Scholar]
- Ridsdale L., Robins D., Fitzgerald A., Jeffery S., McGee L. Epilepsy in general practice: patients' psychological symptoms and their perception of stigma. Br J Gen Pract. 1996 Jun;46(407):365–366. [PMC free article] [PubMed] [Google Scholar]
- Scambler G., Hopkins A. Social class, epileptic activity, and disadvantage at work. J Epidemiol Community Health. 1980 Jun;34(2):129–133. doi: 10.1136/jech.34.2.129. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Zigmond A. S., Snaith R. P. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983 Jun;67(6):361–370. doi: 10.1111/j.1600-0447.1983.tb09716.x. [DOI] [PubMed] [Google Scholar]