Impact of pre-graduation transition on psychosocial outcomes in childhood-onset focal epilepsy

Background Transition from pediatric to adult epilepsy care is increasingly recognized as a determinant of long-term health and social outcomes. This study examined whether transition before school graduation is associated with better adult mental health, social functioning, and employment among individuals with childhood-onset focal epilepsy. Methods We retrospectively analyzed 72 adults (35 females, 37 males; age 19–50 years) with childhood-onset focal epilepsy who received comprehensive inpatient evaluation. Participants were categorized into a pre-graduation group (transition during school years; n = 27) and a post-graduation group (transition after completion of education; n = 45). Primary outcomes were depressive symptoms and social functioning. Secondary outcomes included employment status and workplace epilepsy disclosure. Group differences were assessed using independent t tests and χ 2 tests. Multivariable linear regression was used to examine independent predictors of psychosocial outcomes after adjusting for demographic, clinical, and psychosocial factors. Results Baseline demographic and clinical characteristics did not differ significantly between the two groups. Compared with post-graduation transition, pre-graduation transition was associated with significantly lower depressive symptoms ( p < 0.01) and higher social functioning ( p < 0.05). Employment rate (81.5% vs. 51.1%) was higher in the pre-graduation group ( p < 0.05). In adjusted models, pre-graduation transition independently predicted lower depressive symptoms ( p < 0.01) and higher social functioning ( p < 0.05), even after adjusting for sex, seizure frequency, and other covariates. Conclusion Transitioning to adult care before school graduation was associated with more favorable adult mental health, social participation, and vocational outcomes among individuals with childhood-onset focal epilepsy.