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

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.

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Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: L. Willems and L. Hamann report no conflicts of interest. J.P. Zöllner reports personal fees from Jazz Pharmaceuticals. S. Knake reports personal fees and grants from Angelini Pharma, Bial, Desitin Arzneimittel, Epilog, Kanso, UCB Pharma, UNEEG, and Zogenix. S. Kovac reports grants from Biogen and speaker’s honoraria from Eisai and Jazz Pharmaceuticals. F. von Podewils reports personal fees from UCB Pharma, Arvelle Therapeutics/Angelini Pharma, Desitin Arzneimittel, Zogenix, Eisai, and GW/Jazz Pharmaceuticals, and grants from the State of Mecklenburg-Vorpommern and the Deutsches Zentrum für Luft- und Raumfahrt (DLR). F. Rosenow reports personal fees from Angelini Pharma, Desitin Arzneimittel, Eisai GmbH, Jazz Pharma, Roche Pharma, UCB Pharma, and Zogenix and grants from the Detlev-Wrobel-Fonds for Epilepsy Research, the Chaja-Foundation Frankfurt, the Deutsche Forschungsgemeinschaft, the LOEWE Programme of the State of Hesse, and the European Union. A. Strzelczyk reports personal fees and grants from Angelini Pharma/Arvelle Therapeutics, Desitin Arzneimittel, Eisai, Jazz (GW) Pharmaceuticals companies, Marinus Pharma, Takeda, UCB, UNEEG medical, and Zogenix. The other authors declare that they have no competing interests.