Epilepsia, 48(5):907–912, 2007 Blackwell Publishing, Inc. C  2007 International League Against Epilepsy Social Functioning and Psychological Well-Being of 347 Young Adults with Epilepsy Only—Population-Based, Controlled Study from Finland ∗ Anne Koponen, †Ullamaija Sepp¨ al¨ a, ‡Kai Eriksson, §Pirkko Nieminen, ‖Antti Uutela, ¶Matti Sillanp¨ a¨ a, #Leena Hyv¨ arinen, and ∗∗ Reetta K¨ alvi¨ ainen ∗ Department of Public Health, University of Helsinki, Helsinki, Finland; †Department of Social Policy, University of Helsinki, Helsinki, Finland; ‡Pediatric Neurology Unit, Tampere University Hospital and Pediatric Research Centre, Medical School, University of Tampere, Tampere, Finland; §Department of Psychology, University of Tampere, Tampere, Finland; ‖Department of Health Promotion and Disease Prevention, National Public Health Institute, Helsinki, Finland.; ¶Departments of Pediatric Neurology and Public Health, University of Turku, Turku, Finland; #Finnish Epilepsy Association, Helsinki, Finland; and ∗∗ Kuopio Epilepsy Center, Department of Neurology, University of Kuopio and Kuopio University Hospital, Kuopio, Finland Summary: Purpose: To explore social functioning and psy- chological well-being in a population-based cohort of epilepsy patients compared to matched controls. Methods: A random sample of patients with epilepsy (N = 347) and a healthy control group (N = 430) matched for age, gender and domicile were identified through National Registry of Social Insurance Institution in Finland. The data were collected by postal questionnaire assessing various factors related to social and psychological well-being and were analyzed by using linear regression analysis to compare the study and control groups. Results: The age at onset of epilepsy was significantly asso- ciated with the level of further education and the level of seizure control with the employment status. The patients with epilepsy and lower level of basic education had also significantly lower level of further education, employment, and fewer social rela- tions. Some differences in psychological well-being were also seen in those with matriculation examination when compared to matched controls. Conclusions: In young adults with well-controlled epilepsy and successful basic education, social functioning is compara- ble with healthy peers. The importance of all social and educa- tional support during the time of basic education may be cru- cial to favorable intellectual, functional, and social development later in life. Both professional and informal support is needed in adjunct to conventional treament of epilepsy, which is empha- sized. Key Words: Epilepsy—Education—Employment— Social functioning—Social relations—Psychological well- being—Self-image. Epilepsy is one of the most common chronic neurolog- ical conditions with prevalence of around 1% in popula- tions of the developed countries (Hauser, 2001). Cogni- tive, psychiatric and behavioral disorders in patients with epilepsy, as a group, are increased (Aldenkamp et al., 2004), and some of these difficulties have been described also in patients with “epilepsy only,” i.e., without any ev- ident other neurological or cognitive disabilities and with well-controlled epilepsy. More research has been done regarding psychiatric problems and problems in cogni- tive functions among persons with epilepsy than research about their everyday life, social adjustment, competence and functioning. However, patients with epilepsy also ex- Accepted November 18, 2006. Address correspondence and reprint requests to Dr. Reetta K¨ alvi¨ ainen, Department of Neurology, Kuopio University Hospital, PO Box 1777, 70211 Kuopio, Finland. E-mail: reetta.Kalviainen@Kuh.fi doi: 10.1111/j.1528-1167.2007.01017.x perience more problems in social functioning and psycho- logical well-being than peers in general (Baker et al., 2005) and these are often considered to be even more handicap- ping than seizures themselves (Mirnics et al., 2001). The causes for these difficulties are multifactorial including the underlying etiology and neuropathology, EEG discharges and seizures, antiepileptic drugs (AED) and various other psychosocial factors (Kwan and Brodie, 2001). Several constructs have been used when examining so- cial functioning. When using the concept of “social adjust- ment,” it is defined as the extent to which an individual’s role performance confirms the norms of his or her refer- ence group (John, 2001). More broadly defined “social competence” means reasonable success with major devel- opmental tasks expected for a person of a given age and gender in the context of his or her culture, society and time (Masten and Coatsworth, 1998) and in the most abstract level it is defined as effectiveness interaction, the result 907