Gagandeep Singh1, Apoorva Pauranik2, Bindu Menon3, Birinder S Paul4, Caroline Selai5, Debashish Chowdhury6, Deepak Goel7, H V Srinivas8, Hitant Vohra9, John Duncan10, Kalyani Khona11, Manish Modi12, Man Mohan Mehndiratta13, Parampreet Kharbanda12, Parveen Goel4, Pravina Shah14, Rajinder Bansal4, Renu Addlakha15, Sanjeev Thomas16, Satish Jain17, Urvashi Shah18, V S Saxena19, Veena Sharma20, V V Nadkarni21, Yashoda Wakankar22. 1. Department of Neurology, Dayanand Medical College, Ludhiana, India. Electronic address: g.singh@ucl.ac.uk. 2. Department of Neurology, Mahatma Gandhi Memorial Medical College, Indore, India. 3. Department of Neurology, Narayana Medical College, Nellore, India. 4. Department of Neurology, Dayanand Medical College, Ludhiana, India. 5. UCL Institute of Neurology, Queen Square, London, UK. 6. G.B. Pant Hospital, New Delhi, India. 7. Department of Neurology, Himalayan Institute Hospital Trust University, Dehradun, India. 8. Department of Neurology, Sagar Hospital, Bengaluru, India. 9. Department of Anatomy, Dayanand Medical College, Ludhiana, India. 10. Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK. 11. Wanted Umbrella, New Delhi, India. 12. Department of Neurology, Postgraduate Institute of Medical Education & Research, Chandigarh, India. 13. Janakpuri Superspecialty Hospital, New Delhi, India. 14. Department of Neurology, Fortis Hospital, Mumbai, India. 15. Center for Women's Development Studies, New Delhi, India. 16. Sree Chitra Tirunal Institute for Medical Sciences & Technology, Trivandrum, India. 17. Indian Epilepsy Centre, New Delhi, India. 18. Department of Neurology, K.E.M. Hospital, Mumbai, India. 19. Indian Epilepsy Association, Gurgaon, India. 20. Human Rights Law Network, Chandigarh, India. 21. Department of Neurology, Mangesh Neuro Centre, Indore, India. 22. Samvedana Epilepsy Group, Pune, India.
Abstract
INTRODUCTION: Matrimony remains a challenging psychosocial problem confronting people with epilepsy (PWE). People with epilepsy are less likely to marry; however, their marital prospects are most seriously compromised in arranged marriages. AIMS: The aim of this study was to document marital prospects and outcomes in PWE going through arranged marriage and to propose optimal practices for counseling PWE contemplating arranged marriage. METHODS: A MEDLINE search and literature review were conducted, followed by a cross-disciplinary meeting of experts to generate consensus. RESULTS: People with epilepsy experience high levels of felt and enacted stigma in arranged marriages, but the repercussions are heavily biased against women. Hiding epilepsy is common during marital negotiations but may be associated with poor medication adherence, reduced physician visits, and poor marital outcome. Although divorce rates are generally insubstantial in PWE, divorce rates appear to be higher in PWE undergoing arranged marriages. In these marriages, hiding epilepsy during marital negotiations is a risk factor for divorce. CONCLUSIONS: In communities in which arranged marriages are common, physicians caring for PWE are best-equipped to counsel them about their marital prospects. Marital plans and aspirations should be discussed with the family of the person with epilepsy in a timely and proactive manner. The benefits of disclosing epilepsy during marital negotiations should be underscored.
INTRODUCTION: Matrimony remains a challenging psychosocial problem confronting people with epilepsy (PWE). People with epilepsy are less likely to marry; however, their marital prospects are most seriously compromised in arranged marriages. AIMS: The aim of this study was to document marital prospects and outcomes in PWE going through arranged marriage and to propose optimal practices for counseling PWE contemplating arranged marriage. METHODS: A MEDLINE search and literature review were conducted, followed by a cross-disciplinary meeting of experts to generate consensus. RESULTS:People with epilepsy experience high levels of felt and enacted stigma in arranged marriages, but the repercussions are heavily biased against women. Hiding epilepsy is common during marital negotiations but may be associated with poor medication adherence, reduced physician visits, and poor marital outcome. Although divorce rates are generally insubstantial in PWE, divorce rates appear to be higher in PWE undergoing arranged marriages. In these marriages, hiding epilepsy during marital negotiations is a risk factor for divorce. CONCLUSIONS: In communities in which arranged marriages are common, physicians caring for PWE are best-equipped to counsel them about their marital prospects. Marital plans and aspirations should be discussed with the family of the person with epilepsy in a timely and proactive manner. The benefits of disclosing epilepsy during marital negotiations should be underscored.