A general practice-based prevalence study of epilepsy among adults with intellectual disabilities and of its association with psychiatric disorder, behaviour disturbance and carer stress
2007
Background Although the elevated occurrence of
epilepsy in people with intellectual disabilities (ID) is
well recognized, the nature of seizures and their
association with psychopathology and carer strain
are less clearly understood.The aims were to determine
the prevalence and features of epilepsy in a
community-based population of adults with ID, and
to explore whether the presence of epilepsy was associated
with greater psychopathology or carer strain.
Methods Data were collected on the age, gender,
place of residence, adaptive and challenging behaviour,
social abilities and psychiatric status of 318
adults from 40 general practices, together with the
degree of malaise and strain of family carers. For
participants with epilepsy, a nurse collected information
on seizures, investigations, treatment and
carer concerns by interview. Association between
epilepsy and psychiatric morbidity, challenging
behaviour and caregiver malaise or strain, was
explored by comparing those with epilepsy with a
comparison group matched on adaptive behaviour.
Results Fifty-eight participants (18%) had epilepsy:
26% were seizure free, but 34% had extremely
poorly controlled seizures. Earlier onset and seizure
frequency were associated with adaptive behaviour.
Carer concerns were related to seizure frequency
and a history of injury. There were no significant
differences in psychopathology, carer malaise or caregiver
strain between the matched epilepsy and
non-epilepsy groups.
Conclusions This study supports the high occurrence
and chronicity of epilepsy among people with
ID.While psychopathology and carer strain is
common within this population, underlying
disability-related factors appear to be more important
than the presence of epilepsy per se.
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