نتایج پریشانی و سلامت روانی جدی برای افراد مبتلا به صرع در فقر

Epidemiology literature demonstrates socioeconomic status as an important variable for outcomes in persons with epilepsy. However, no previous studies have analyzed the association between poverty and epilepsy in the United States. Forty-one percent (246/604) of persons with a history of epilepsy (PWHE) in the 2005 California Health Interview Survey (n = 43,020) had an annual income <200% Federal Poverty Level (FPL), adjusted lifetime prevalence rate 0.5% [98.33% CI 0.4–0.7]. Four groups are presented in the analyses: (1) those with a history of epilepsy <200% FPL, (2) those with a history of epilepsy ≥200% FPL, (3) those not reporting a history of epilepsy <200% FPL and (4) those not reporting a history of epilepsy ≥200% FPL. PWHE in poverty reported significantly higher amounts of serious psychological distress, based on the validated Kessler 6 (K6) scale, than both non-epilepsy populations. After adjusting for demographics and other comorbid conditions, logistic regression analyses show PWHE in poverty are significantly more likely to report fair or poor self-rated health status when compared to the PWHE not in poverty and both non-epilepsy populations. PWHE in poverty are also more likely to report ≥14 generally unhealthy days and ≥14 physically unhealthy days in the past 30 days compared to the PWHE not in poverty and both non-epilepsy populations. Psychological well-being needs to be incorporated into any comprehensive treatment strategy for managing epilepsy.

Epilepsy effects many areas of function; education, employment, family relations, recreation and social activities.1 Persons with epilepsy also face stigma, discrimination and fear of embarrassment which all create problems for self-esteem.2 Persons with epilepsy are also more likely to be economically disadvantaged.3, 4 and 5 To identify differential needs in health care, it is imperative to identify conditions that disproportionately affect socio-economically deprived people. In the U.S., state-based programs typically focus on the most prevalent conditions such as cancer, diabetes and cardiovascular disease. However, a recent publication by the Centers for Disease Control (CDC) has acknowledged the importance of less prevalent conditions, such as epilepsy.6 Objectives of the U.S. government's report Healthy People 2010 include increasing both the quality and years of healthy life and to eliminate health disparities. 7 The limited knowledge between epilepsy and low socioeconomic status has been highlighted at two U.S. conferences held in conjunction with Centers for Disease Control in 1995 and 2003. 8