Introduction: Childhood-onset epilepsy during the years of transition to adulthood may affect normal social,
physical, and mental development, frequently leading to psychosocial and health-related problems in the
Objective: This study aimed to describe the main characteristics of patients in transition and to identify risk factors
for poor psychosocial outcome in adolescents and young adults with epilepsy.
Methods: Patients with epilepsy, 15–25 years of age, who visited the Kempenhaeghe Epilepsy Transition Clinic
from March 2012 to December 2014 were included (n = 138). Predefined risk scores for medical, educational/occupational
status, and independence/separation/identity were obtained, along with individual risk profile scores
for poor psychosocial outcome. Multivariate linear regression analysis and discriminant analysis were used to
identify variables associated with an increased risk of poor long-term psychosocial outcome.
Results: Demographic, epilepsy-related, and psychosocial variables associated with a high risk of poor long-term
outcome were lower intelligence, higher seizure frequency, ongoing seizures, and an unsupportive and unstable
family environment. Using the aforementioned factors in combination, we were able to correctly classify the
majority (55.1%) of the patients regarding their risk of poor psychosocial outcome.
Conclusion: Our analysis may allow early identification of patients at high risk of prevention, preferably at
pretransition age. The combination of a chronic refractory epilepsy and an unstable family environment constitutes
a higher risk of transition problems and poor outcome in adulthood. As a consequence, early interventions
should be put into place to protect youth at risk of poor transition outcome.