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Research Article| Volume 144, 109255, July 2023

Unemployment and early retirement among patients with epilepsy – A study on predictors, resilience factors and occupational reintegration measures

  • Laurent M. Willems
    Correspondence
    Corresponding author at: Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Goethe-University Frankfurt, Schleusenweg 2-16, 60528 Frankfurt am Main, Germany.
    Affiliations
    Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe-University and University Hospital Frankfurt, Frankfurt am Main, Germany

    LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Frankfurt am Main, Germany
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  • Johann Philipp Zöllner
    Affiliations
    Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe-University and University Hospital Frankfurt, Frankfurt am Main, Germany

    LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Frankfurt am Main, Germany
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  • Laura Hamann
    Affiliations
    Department of Neurology, University Hospital Greifswald, Greifswald, Germany
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  • Susanne Knake
    Affiliations
    Epilepsy Center Hessen and Department of Neurology, Philipps-University Marburg, Marburg, Germany
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  • Stjepana Kovac
    Affiliations
    Epilepsy Center Münster-Osnabrück, Department of Neurology, Institute of Translational Neurology, University of Münster, Münster, Germany
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  • Felix von Podewils
    Affiliations
    Department of Neurology, University Hospital Greifswald, Greifswald, Germany
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  • Felix Rosenow
    Affiliations
    Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe-University and University Hospital Frankfurt, Frankfurt am Main, Germany

    LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Frankfurt am Main, Germany
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  • Adam Strzelczyk
    Affiliations
    Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe-University and University Hospital Frankfurt, Frankfurt am Main, Germany

    LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Frankfurt am Main, Germany
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      Highlights

      • Unemployment and early retirement rates were high at 8.3% and 18.0%, respectively.
      • Relevant disability and frequent seizures were predictors of loss of employment.
      • Seizure freedom was identified as a resilience factor for job retention.
      • Most patients would be able to continue working with moderate restrictions.
      • Recent use of occupational reintegration matters was rarely reported.

      Abstract

      The primary aim of this study was to identify predictors and resilience factors for unemployment and early retirement in patients with epilepsy of working age based on data from a multicenter German cohort study performed in 2020 (n = 456) by using multivariate binary logistic regression analysis. A second aim was to assess the assumed working ability of patients as well as the use of occupational reintegration measures. The unemployment rate was 8.3%, and 18% of patients had retired early due to epilepsy. Multivariate binary logistic regression analysis identified the presence of a relevant disability and frequent seizures as significant predictors of unemployment and early retirement, while seizures in remission were the only resilience factor associated with job retention. Regarding occupational incapacity, at the time of the survey, most of the patients in early retirement or unemployment were fit for work in their original or extended occupational setting. The proportion of patients with recent epilepsy-related occupational retraining (0.4%) or job changes (0.9%) was low, and only 2.4% reported an epilepsy-related reduction in work time. These findings underline the persistent disadvantage of patients with epilepsy in the professional field and the urgent need for effective, comprehensive work reintegration measures that must be made accessible for all patients.

      Graphical abstract

      Keywords

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