Indian J. Psychiat., (1981), 23(2), 152—155 ... - Semantic Scholar

Indian J.

Psychiat.,

(1981), 23(2),

152—155

EMPLOYABILITY A N D W O R K A D J U S T M E N T OF EPILEPTIC P A T I E N T S S. P. GUPTA 1 , M.S.W., LL.B., Ph.D., D.R.M. SUMMARY Employability and work adjustment of all the 116 adult epileptics patients of Agra District who had attended the out-p-.ticiit department of Agra Mental Hospital during a period of 3 years was studied through a follow-up investigation. 32.76% patients were found to be unemployed and among the gainfully employed patients and housewives 44.6% had satisfactory work adjustment, 32.4% had slight impairment, 28.6% moderate and 1.4% showed severe impairment and their occupational functioning.

Several reports of the investigations on the problem of employment and employability of epileptics are available. Pinanski (1947) studied the work records of 1015 epileptics and found an increase in the percentage of epileptics successfully employed during the war. Lord Cohen (1956) reported t h a t many epileptics, particularly those with frequent major fits, could be more often employed. Gordon and Russel (1958) found 10% unemployed among epileptics in a time of very low unemployment. Wilson et al. (1960) and Dennerll et al. (1966) observed t h a t lower intelligence, more frequent fits, grandmal fits and personality disorders h a d a correlation with unemployment among epileptics. Pond a n d Bidwell (1960) reported that 5 7 % adult epileptics had serious difficulties with employment because of epilepsy at some time in their career and J o n e s (1965) found employment difficulties in two thirds of the epileptics studied by him. Porter (1968), Dennerll and R a y m o n d (1970), R o d i n et al. (1972) and Sorcl (1972) also studied the problems of employment and work adjustment of these patients in different industries. I n I n d i a V i r m a n i et al. (1975) have also studied this problem. MATERIAL AND METHOD

Present investigation was undertaken on 116 patients who were (i) registered at the out-patient d e p a r t m e n t of Agra M e n t a l Hospital during 1972-74 ; (ii) residing with-

in Agra district ; (iii) who were aged 16 and above and (iv) diagnosed as 'epileptic'. T h e m a i n object of the study was to find out various psychosocial problems related to epilepsy. P a t i e n t s a n d their family members were contacted a n d interviewed t h r o u g h personal visits to their houses and information collected was recorded on an interview schedule. This p a p e r is a partial report of the above investigation which aims to focus the problems of employability and work adjustment of these patients. Characteristics of the s a m p l e : 116 patients w h o formed the sample of the present investigation belonged to different socio-economic and clinical groups. 91 (78.45%) patients were from u r b a n and remaining 25 (21.55%) were from r u r a l area. 70 (60.35%) were males and 46 (39.65%) were females and 89 (76.72%) were below 30 years. 107 p a t i e n t s (92.2%) were suffering from g r a n d m a l epilepsy, 3 (2.59%) from petitmal, 4 (3.45%) from psycho-motor a n d remaining 2 (1.74%) were cases of Jacksonian epilepsy. O c c u pation wise break-up of all these patients is given in Table 1. I n this T a b l e a 'gainfully employed' person is one whose main activity is p a r t i cipation in any economically productive work by his physical or m e n t a l activity. Work involves not only actual work b u t also effective supervision and direction of work. 'Housewife' is a w o m a n w h o is engaged

•Senior Research Officer, W. H. O- Field Research Centre, Mental Hospital, AGRA-282 002.

WORK ADJUSTMENT OF EPILEPTIC PATIENTS primarily in household duties such as working for own household a n d performing one's own household duties. TABLE

1—Occupationwise

distribution

of

the

patients Type of occupation

Unemployed Students

Male (N = 70) N.

%

30 3

37

Totp.l (N = 116)

N.

%

N.

%

42.9

8

17.4

38

32.8

4.3

1

2.2

4

3.4

31

73.9

34

29.3

3

6.5

40

34.5

Housewives Gainfully employed

Female (N=460)

52.8

D a t a in T a b l e 1 show t h a t 3 2 . 8 % were unemployed, 3 . 4 % were students a n d 2 9 . 3 % (73.9% of t h e females) were housewives. T h u s t h e n u m b e r of gainfully employed p a t i e n t s was only 40 (i.e. 3 4 . 5 % of the entire series). T h i s is in conformity with the 3 5 % of the gainfully employed patients seen by V i r m a n i et al. (1975) in their series. 32.76% u n e m p l o y m e n t in present series is slightly higher from 2 6 . 6 % reported by Bagadia et al. (1973). Sex wise break-up shows more u n e m ployment among males (42.9%) t h a n in females (17.4%). Female unemployeds were those w h o were neither gainfully employed n o r were engaged in household chores. However 6.50% gainfully employed females in present series a r e more of less equal to 6 . 7 % figures of working female population of the c a t c h m e n t area. 5 2 . 9 % gainfully employed males are also more or less equal to 5 2 . 2 % of total m a l e working population of the area. O u t of t h e 38 unemployed patients 14 (12%) of all patients were simple epileptics, 5 (4.3%) were epileptics w h o also h a d history of psychotic illness a n d remaining 19 (16.4%) were epileptics who h a d m e n t a l retardation along with epilepsy (3 i.e. 2 . 6 % h a d m o d e r a t e a n d 16 i.e. 13.8% h a d severe m e n t a l retardation.)

153

Work Adjustment : Information a b o u t the work adjustment of gainfully employed a n d housewives w a s obtained from t h e p a t i e n t s and/or key informant w h o h a d direct face to face contact with t h e p a t i e n t on a daily or almost daily basis over t h e last 6 m o n t h s . T h e work adjustment was r a t e d on a four point scale a n d n o work adjustment inventory was utilized for evaluating it. (i) No Impairment : w a s rated w h e r e patient w a s working satisfactorily a n d efficiently, in case of housewives m a n a g i n g the household efficiently. (ii) Slight impairmet : where the p a t i e n t h a d minor difficulties i n working satisfactorily a n d efficiently. I n case of housewives m a n a g i n g t h e household with some difficulty. (iii) Moderate impairment : where t h e worker h a d difficulties in coping with the work a n d lack of interest or dislike, in case of housewives considerable difficulty in m a n a g ing t h e household. (iv) Severe impairment : was rated w h e r e the worker showed inefficiency or m a r k e d lack of interest or dislike for the j o b , in case of housewives, frequent a n d marked incapacity of m a n a g i n g the household. O u t of the 74 patients (gainfully employed a n d housewives) 33 patients (44.6%) showed n o i m p a i r m e n t in their occupational functioning, 24 p a t i e n t s (32.4%) had slight impairment, 16 patients (21.6%) h a d moderate i m p a i r m e n t a n d it was only in one case (1.3%) where severe i m p a i r m e n t was reported (see table 2 below) : W o r k adjustment in three different groups of p a t i e n t s shows t h a t ' n o i m p a i r m e n t ' was higher among simple epileptic patients (49.0%) followed by epileptics w h o h a d history of psychotic episodes (40.0%)

S. P . GUPTA

154

TABLE 2—Work Adjustment

Work adjustment

Simple epileptics (all types) (N=51) N. %

Epilepi :ics with history of psychosis (N = lo) N. /o

N=74 Mentally subnormal epileptics ( N = 8 ) N. %

Total (N=74)

%

N.

No impairment

25

49.00

6

40.00

2

25.0

33

44.60

Slight impairment

20

39.20

4

26.70

0

0.00

24

32.40

Moderateaimpairment

6

11.86

5

33.30

5

62.50

16

21.60

Severe imparment

0

0.00

0

0.00

1

12.50

1

1.40

X»=29.80, d. f. = 3, p < 0 . 0 1 .

and lowest in mentally subnormal epileptics i. e. 2 5 . 0 % . Slight i m p a i r m e n t was observed in t h e same order. 3 9 . 2 % in first group, 26.7% in second a n d 0 % in the last. M o d e r a t e impairment was however highest (62.5%) among mentally subnormals followed by psychotic group (33.3%) and least (11.8%) in simple epileptics. Severe impairaent was rated only in one case of mentally subnormal group. COMMENTS

T h e findings of the present investigation provide us statistics about the employability and unemployment among the epileptic patients seen a t t h e out patient department of a Mental Hospital. Assessment of work adjustment as has been found in the present investigation is in agreement with those reported by earlier investigators (Gordon a n d Russel, 1958 ; Wilson et. a l . , 1960 ; Pond and Bidwell, 1960 and Dennerll et a l . , 1966) that epilepsy alone neither affects t h e j o b prospects of the individual nor it affects the occupational functioning and his capacity to do the work. It is mental subnormality, a n d associated disorders, which generally come in the way of both employment a n d work adjustment.

ACKNOWLEDGEMENTS

Sincere thanks a r e d u e to Prof. B. S. Yadav, D r . S. M a t h u r , Dr. Rajeshwar Prasad, D r . T . H a r d i n g for their valuable help.

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(1973).

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psycho social study of 180 cases of epilepsy. Indian J . Psychiat, 15, 391. COHEN, LORD (1956). 'Medical care of epileptics' London, H . M. S. O . DENNERLL, R.,

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