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several broken negotiations. Despite its enormous medical and social implications, little information is available
to guide the clinician to answer this question. Through
a questionnaire survey, we investigated the prevalence of
concealment/disclosure of the history of epilepsy and its
consequences on the married life of women with epilepsy
in Kerala, southern India.
1007
1008
D. SANTOSH ET AL.
TABLE 1. The questionnaire
Year SD (range)
Age (years)
Age at epilepsy onset (years)
Duration of epilepsy (years)
Duration after marriage (years)
Religion
Hindu
Muslim
Christian
Education
Lower school
High school
College
Professional
Occupation
Housework only
Employed
Type of marriage
Arranged by parents/relatives
Love marriage
Knowledge about spouse prior to marriage
Unknown
Relative
Neighbor
Type of living family
Nuclear
Mixed
Predominant seizure type
Complex partial seizure
Generalized seizures
Epilepsy syndromic diagnosis
Temporal lobe epilepsy
Juvenile myoclonic epilepsy
Other/uncertain
53 (64.6)
17 (20.7)
12 (14.6)
2 (2.4)
43 (52.4)
33 (40.2)
4 (4.9)
60 (73.2)
22 (26.8)
67 (81.7)
15 (18.3)
41 (50.0)
23 (28.0)
18 (22.0)
17 (20.7)
65 (79.3)
52 (63.4)
30 (36.6)
42 (51.2)
8 (9.8)
32 (39.0)
RESULTS
The demographic and clinical characteristics of 82 married women with epilepsy are provided in Table 2. Their
age ranged from 2259 years, and duration of marriage
ranged from 535 years. Eighty-two percent of the marriages were arranged by parents. Fifty percent of our patients had never met the spouse before marriage. Nearly
all of them have had at least 10 years of school education,
and over one-third had been to college. Twenty-seven percent of them were employed. The distribution according
to religion was 64.6% Hindu, 20.7% Muslim, and 14.6%
Christian. Fifty-two (63.4%) patients had complex partial
seizures, remainder had generalized tonicclonic seizures.
A diagnosis of temporal lobe epilepsy and juvenile myoclonic epilepsy was evident in 42 and eight patients,
respectively.
Prevalence of concealment/disclosure
At the time of marriage, 45 (54.9%) concealed and 37
(45.1%) disclosed the history of epilepsy. Out of the patients who disclosed, 20 (54.1%) informed the spouse
Attributes
Age at marriage
Age at epilepsy onset
Education
School
College
Religion
Hindu
Muslim
Christian
Employment
Employed
Unemployed
Seizure frequency
5 per year
6 per year
Type of marriage
Arranged
Love
No. of prior broken
marriage negotiations
Marriage outcomes
Divorced
Separated
Disturbed
Satisfied
Concealed
N = 45
Mean SD
Disclosed
N = 37
Mean SD
Significance
(p)
23.0 3.7
15.0 4.4
N (%)
23.6 4.0
14.2 4.7
N (%)
NS
NS
26 (57.8)
19 (42.2)
19 (51.4)
18 (48.6)
NS
30 (66.7)
9 (20.0)
6 (13.3)
23 (62.2)
8 (21.6)
6 (16.2)
6 (13.3)
39 (86.7)
16 (43.2)
21 (56.8)
0.002
32 (71.1)
13 (28.9)
27 (73.0)
10 (27.0)
NS
38 (84.4)
7 (15.6)
06
29 (78.4)
8 (21.6)
28
NS
8 (17.7)
9 (20.0)
20 (44.4)
8 (17.8)
1 (2.7)
1 (2.7)
6 (16.2)
29 (78.4)
1009
NS
NS
<0.001
<0.001
<0.001
<0.001
1010
D. SANTOSH ET AL.
REFERENCES
Agarwal P, Mehndiratta MM, Antony AR, Kumar N, Dwivedi RN,
Sharma P, Kumar S. (2006) Epilepsy in India: nuptiality behaviour
and fertility. Seizure 15:409415.
Amir M, Roziner I, Knoll A, Neufeld MY. (1999) Self-efficacy and
social support as mediators in the relation between disease severity and quality of life in patients with epilepsy. Epilepsia 40:216
224.
Department of Health, Government of Kerala. (2004) A study on gender based violence in Kerala. Sakhi Resource Center for Women,
Trivandrum, Kerala.