Social context as a risk factor for psychopathology in children with epilepsy
Introduction from Dr Markus Reuber, editor-in-chief of Seizure
More commonly than not, the medical care for patients with epilepsy strongly focuses on the seizures. Detailed enquiry about possible medication side-effects or mental health symptoms may fall by the wayside when patients are seen in time-pressured circumstances. Scant attention is paid to the discussion of “lifestyle” issues, such as questions related to work or study, partnership, family planning, or parenthood – never mind patients’ experience of epilepsy-associated stigma.
My Editor’s Choice from the current issue of Seizure, a review by Katharine Bailey and Nancie Im-Bolter examines epilepsy from a sociological point of view and reminds us that seizures are only one modest aspect of the lived experience of epilepsy (1). In my experience Paediatricians and Paediatric Neurologist tend to have a better grasp of the effects of medical conditions on domains such as family life, education, personal and social development than Clinicians providing care for adults, so it is perhaps no surprise that this review focuses on the (more substantial) paediatric literature. However, the approach taken – the application of Bronfenbrenner’s ecological model of development (2) – and the findings, are just as relevant in adult neurology.
The most important lesson from the broad understanding of epilepsy implicit in the review by Bailey and Im-Bolter is that seizures are not the only treatable manifestation of the disorder. There is much scope for reducing disability and distress by paying attention to smaller and larger social structures contributing to patients’ understanding of epilepsy, their ability to cope with the disorder and their risk of psychiatric comorbidities.
1) Bailey K & Im-Boulter, N. Social context as a risk factor for psychopathology in children with epilepsy. Seizure 2018
2) Bronfenbrenner U. Toward an experimental ecology of human development. Am Psychol;1977:513-531