Semergen · 2026
[Impact of epilepsy-related stigma on employability: A review of the evidence for primary care practice].
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Vicente-Herrero M T, Ramírez-Iñiguez de la Torre M V, Capdevila-García L, López-González Á A, Maisanava Martín C N, Ruiz-Flores Bistuer M
Аннотация
INTRODUCTION: Epilepsy is a common chronic neurological disorder that entails a substantial psychosocial and occupational impact mediated by stigma. Available studies show that, compared with the general population, people with epilepsy have higher rates of unemployment, work disability, absenteeism and presenteeism, as well as poorer health-related quality of life. The aim of this study is to analyze the impact of stigma on the employment situation of people with epilepsy and its implications for primary care and occupational medicine.
METHOD: A structured narrative review with critical appraisal of the evidence was conducted in PubMed, MEDLINE, Web of Science, PsycINFO, the Cochrane Library and EMBASE (2006-2025). Studies in adult populations that assessed stigma, employment and quality of life in epilepsy were included. Methodological quality was assessed using SANRA, AMSTAR-2, GRADE and the Newcastle-Ottawa Scale complemented by GRADE.
RESULTS: Stigma is associated with higher unemployment, early retirement, work disability and poorer quality of life. Seizure frequency, drug-resistant epilepsy, psychiatric comorbidity, low educational level and certain working conditions are related to worse employment outcomes and greater social vulnerability. Concealment of the diagnosis hinders workplace adaptations. Adverse effects of antiseizure medications may affect work performance and safety.
CONCLUSIONS: Stigma remains a determinant of occupational exclusion in epilepsy. Primary care and occupational medicine play complementary roles in the detection and assessment of stigma and in its management through clinical and psychosocial interventions, individualized workplace accommodations and inclusive employment policies.
METHOD: A structured narrative review with critical appraisal of the evidence was conducted in PubMed, MEDLINE, Web of Science, PsycINFO, the Cochrane Library and EMBASE (2006-2025). Studies in adult populations that assessed stigma, employment and quality of life in epilepsy were included. Methodological quality was assessed using SANRA, AMSTAR-2, GRADE and the Newcastle-Ottawa Scale complemented by GRADE.
RESULTS: Stigma is associated with higher unemployment, early retirement, work disability and poorer quality of life. Seizure frequency, drug-resistant epilepsy, psychiatric comorbidity, low educational level and certain working conditions are related to worse employment outcomes and greater social vulnerability. Concealment of the diagnosis hinders workplace adaptations. Adverse effects of antiseizure medications may affect work performance and safety.
CONCLUSIONS: Stigma remains a determinant of occupational exclusion in epilepsy. Primary care and occupational medicine play complementary roles in the detection and assessment of stigma and in its management through clinical and psychosocial interventions, individualized workplace accommodations and inclusive employment policies.