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Budikayanti A, Rahmi I, Amalini L, Lastri DN, Herqutanto, Prihartono J, Octaviana F. Screening of Major Depression Disorder in Patients With Epilepsy in Indonesian National Referral Hospital. Neurol Clin Pract 2023; 13:e200152. [PMID: 37564157 PMCID: PMC10411967 DOI: 10.1212/cpj.0000000000200152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 02/15/2023] [Indexed: 08/12/2023]
Abstract
Background and Objectives Major depressive disorder (MDD) is a common psychiatric disorder in patients with epilepsy (PWE). The Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) is one of the MDD screening tools used in PWE. This study aims to determine the accuracy of the valid and reliable NDDI-E Indonesian version as an MDD screening tool in PWE and investigate the prevalence and risk factors for the development of MDD in PWE. Methods A diagnostic cross-sectional study was conducted at Cipto Mangunkusumo National Referral Hospital, Indonesia. Patients were PWE aged 18 years or older who visited the epilepsy outpatient clinic. The valid and reliable NDDI-E Indonesian version and Mini International Neuropsychiatric Interview (MINI) International Classification of Disease, 10th Revision (ICD-10) were used to diagnose MDD. In phase II of the study, diagnostic accuracy was evaluated using the receiver operative characteristic (ROC) curve method to obtain the area under the curve (AUC) and diagnostic 2 x 2 table to determine the cutoff point, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). During phase III of the study, eligible individuals were screened for MDD using the NDDI-E Indonesian version. Demographic and clinical data were collected. Data analysis was performed using the χ2 test, Mann-Whitney test, and multivariate logistic regression analysis. Results A total of 105 individuals were involved, and only 23 of them were found to experience MDD based on MINI ICD-10. The best cutoff point for the NDDI-E Indonesian version was ≥11, with a sensitivity of 91.3%, specificity 89%, PPV 70%, and NPV 97.3%. The AUC obtained from ROC analysis was 97.5% (95% CI 95-99%, p < 0.001). Then, the survey was completed by 79 individuals, predominantly male, mostly within the age range of 26-45 years. The prevalence of MDD in PWE was 50.6%, and the significant risk factors were seizure frequency ≥8 times a year and the presence of chronic diseases (p < 0.001). Discussion The NDDI-E Indonesian version was a screening tool with a high diagnostic accuracy to detect MDD in PWE at a cutoff point of 11. Poor seizure control and the presence of other chronic diseases were the risk factors correlated with MDD development in PWE.
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Affiliation(s)
- Astri Budikayanti
- Department of Neurology (AB, IR, LA, DNL, FO) and Community Medicine Department (HH, JP), Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Izati Rahmi
- Department of Neurology (AB, IR, LA, DNL, FO) and Community Medicine Department (HH, JP), Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Lilir Amalini
- Department of Neurology (AB, IR, LA, DNL, FO) and Community Medicine Department (HH, JP), Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Diatri Nari Lastri
- Department of Neurology (AB, IR, LA, DNL, FO) and Community Medicine Department (HH, JP), Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Herqutanto
- Department of Neurology (AB, IR, LA, DNL, FO) and Community Medicine Department (HH, JP), Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Joedo Prihartono
- Department of Neurology (AB, IR, LA, DNL, FO) and Community Medicine Department (HH, JP), Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Fitri Octaviana
- Department of Neurology (AB, IR, LA, DNL, FO) and Community Medicine Department (HH, JP), Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
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Strzelczyk A, Aledo-Serrano A, Coppola A, Didelot A, Bates E, Sainz-Fuertes R, Lawthom C. The impact of epilepsy on quality of life: Findings from a European survey. Epilepsy Behav 2023; 142:109179. [PMID: 37058861 DOI: 10.1016/j.yebeh.2023.109179] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 03/10/2023] [Accepted: 03/10/2023] [Indexed: 04/16/2023]
Abstract
INTRODUCTION Epilepsy is a serious neurological disorder affecting the quality of life (QoL) of people with this condition. A survey was conducted in five European countries (France, Germany, Italy, Spain, and the UK) to understand the impact and burden of epilepsy and its treatment on the lives of people with epilepsy (PWE). METHODS Five hundred PWE (taking >1 antiseizure medication [ASM]) and 500 matched controls completed a 30-minute online questionnaire. The 12-Item Short Form Survey (SF-12) was used to measure QoL and the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) was used to screen for major depressive disorder (MDD) symptoms. RESULTS Comorbidities such as migraine, high cholesterol, osteoporosis, and Type 1 diabetes were reported more commonly in PWE, while anxiety disorders, high blood pressure, skin disorders, and mood disorders were more common in controls. However, compared to controls, a significantly higher percentage of PWE had an NDDI-E score of 15-24 (54% vs 35%; p < 0.0001), indicative of MDD symptoms. Significantly more PWE than controls were part-time employed (15% vs 11%; p = 0.03). People with epilepsy had a significantly lower total SF-12 score than controls across the physical and the mental components; compared to controls, a significantly higher proportion of PWE defined their general health as 'poor' or 'fair' and felt limited in carrying out daily and work activities. Among PWE, those taking ≥3 ASMs were more likely to experience difficulties in carrying out these activities than those on two ASMs. Ability to drive, mood, and level of self-esteem were reported as concerns for PWE. CONCLUSION Epilepsy has a major impact on the physical and mental health of PWE, interfering with their daily and work activities and overall QoL, and its treatment might also contribute to a lower QoL. The impact of epilepsy on mood and mental health might be under-recognized.
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Affiliation(s)
- Adam Strzelczyk
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Goethe University, Frankfurt am Main, Germany.
| | - Angel Aledo-Serrano
- Epilepsy Program, Department of Neurology, Ruber Internacional Hospital, Madrid, Spain
| | - Antonietta Coppola
- Epilepsy Centre, Department of Neuroscience, Odontostomatological and Reproductive Sciences, Federico II University of Naples, Naples, Italy
| | - Adrien Didelot
- Department of Neurology, Centre Hospitalier Saint Joseph Saint Luc, Lyon, France
| | | | | | - Charlotte Lawthom
- Department of Neurology, Aneurin Bevan University Health Board, Newport, United Kingdom
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Qin SK, Yang ZX, Guan ZW, Zhang JH, Ping X, Lu Y, Pei L. Exploring the association between epilepsy and depression: A systematic review and meta-analysis. PLoS One 2022; 17:e0278907. [PMID: 36520790 PMCID: PMC9754200 DOI: 10.1371/journal.pone.0278907] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE This study offers meta-analytic data on the potential association between epilepsy and depression especially for the prevalence of depression in epilepsy or vice versa. METHODS The relevant studies were searched and identified from nine electronic databases. Studies that mentioned the prevalence and/or incidence of epilepsy and depression were included. Hand searches were also included. The search language was English and the search time was through May 2022. Where feasible, random-effects models were used to generate pooled estimates. RESULTS After screening electronic databases and other resources, 48 studies from 6,234 citations were included in this meta-analysis. The period prevalence of epilepsy ranged from 1% to 6% in patients with depression. In population-based settings, the pooled period prevalence of depression in patients with epilepsy was 27% (95% CI, 23-31) and 34% in clinical settings (95% CI, 30-39). Twenty studies reported that seizure frequency, low income, unemployment of the patients, perception of stigma, anxiety, being female, unmarried status, disease course, worse quality of life, higher disability scores, and focal-impaired awareness seizures were risk factors for depression. CONCLUSION Our study found that epilepsy was associated with an increased risk of depression. Depression was associated with the severity of epilepsy.
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Affiliation(s)
- Shao-kun Qin
- Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
- Hebei Key Laboratory of Turbidity, Shijiazhuang, Hebei, China
| | - Zi-xian Yang
- Hebei Key Laboratory of Turbidity, Shijiazhuang, Hebei, China
- School of Chinese Medicine, North China University of Science and Technology, Tangshan, Hebei, China
| | - Zhen-wei Guan
- Hebei Key Laboratory of Turbidity, Shijiazhuang, Hebei, China
- Hebei Academy of Chinese Medicine Sciences, Shijiazhuang, Hebei, China
| | - Jin-hu Zhang
- Hebei Key Laboratory of Turbidity, Shijiazhuang, Hebei, China
- Hebei Academy of Chinese Medicine Sciences, Shijiazhuang, Hebei, China
| | - Xin Ping
- Hebei Key Laboratory of Turbidity, Shijiazhuang, Hebei, China
- Hebei Academy of Chinese Medicine Sciences, Shijiazhuang, Hebei, China
| | - Ye Lu
- Hebei Key Laboratory of Turbidity, Shijiazhuang, Hebei, China
- Hebei Academy of Chinese Medicine Sciences, Shijiazhuang, Hebei, China
- * E-mail: (YL); (LP)
| | - Lin Pei
- Hebei Key Laboratory of Turbidity, Shijiazhuang, Hebei, China
- Hebei Academy of Chinese Medicine Sciences, Shijiazhuang, Hebei, China
- * E-mail: (YL); (LP)
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Puteikis K, Mameniškienė R. Psychometric properties of the Lithuanian version of the NDDI-E in persons with epilepsy and suicidal ideation. Epilepsy Behav 2022; 136:108913. [PMID: 36155364 DOI: 10.1016/j.yebeh.2022.108913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 09/01/2022] [Accepted: 09/02/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Suicidality and depression are associated with worse epilepsy outcomes, but their screening in routine clinical practice remains insufficient and may improve with the validation of brief and accessible psychometric tools. We explored the psychometric properties of the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) in the Lithuanian population, which has one of the highest suicide rates globally. METHODS We conducted a cross-sectional anonymous survey among adult outpatients visiting a tertiary epilepsy clinic in Vilnius, Lithuania. People with epilepsy (PWE) provided demographic and clinical information and completed the Geriatric depression scale (GDS), the Hospital anxiety and depression scale (HADS), the Beck depression inventory (BDI), the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) and the Generalized anxiety scale-7 (GAD-7). Suicidal ideation was defined as a non-zero score on the suicide item of the BDI and clinically relevant levels of depression - as a total BDI score of >16. Psychometric properties of the NDDI-E were evaluated by measuring its internal consistency, dimensionality, correlation with other depression scales, and by conducting receiver operating characteristic analysis for the detection of suicidal ideation and symptoms of depression. RESULTS The study sample consisted of 246 PWE (average age 39.9 ± 16.3 years, 101 [41.1%] male), of them 31 (12.6%) and 41 (19.5% of those who completed the BDI) were identified with suicidal ideation or significant symptoms of depression, respectively. On average, PWE scored 10.4 ± 4.2 points on the NDDI-E. The instrument had good internal consistency (Cronbach's alpha = 0.863, n = 235), item-item and item-total correlation (>0.30). In factor analysis, its items comprised a single factor distinct from the GAD-7. The NDDI-E strongly correlated with other depression scales (r = 0.657 [GDS, n = 201], r = 0.657 [BDI, n = 201], r = 0.623 [HADS-D, n = 231], p < 0.001 for all). The NDDI-E had good diagnostic properties in discerning suicidal ideation (AUC = 0.858, 95%CI = 0.791-0.925). The isolated suicide item of the NDDI-E had acceptable properties in detecting suicidal ideation (AUC = 0.821, 95%CI = 0.724-0.918) as well. CONCLUSION The Lithuanian NDDI-E was shown to have good psychometric properties comparable to other versions of this scale. The NDDI-E is endorsed as a short and accessible instrument for estimating suicidal ideation among Lithuanian PWE.
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Affiliation(s)
| | - Rūta Mameniškienė
- Centre for Neurology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
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Rashid H, Upadhyay AD, Pandey RM, Katyal J. Point prevalence of depression in persons with active epilepsy and impact of methodological moderators: A systematic review and meta-analysis. Epilepsy Behav 2021; 125:108394. [PMID: 34794012 DOI: 10.1016/j.yebeh.2021.108394] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 10/06/2021] [Accepted: 10/21/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The aim of this study was to determine the pooled prevalence of depression in persons with epilepsy and assess the methodological moderators affecting the prevalence estimates. METHODS Five electronic databases PubMed, The Cochrane Library, EMBASE, WHO Global Index Medicus, and Clinicaltrial.gov were searched for studies reporting prevalence of depression in PWE ≥ 18 years of age in any setting. RESULTS Out of 13,873 studies, after deduplication and screening, 56 studies with 10,527 PWE met the eligibility criteria. The overall pooled prevalence of depression in PWE was 32% (95%confidence interval [CI] 28-35%) and significant heterogeneity (Chi-square = 1171.53, p = 0.00; τ2 = 0.02; I2 = 94.36%). Prevalence has doubled in the recent years (16% in 2000-2005 vs. 35% in 2016-2020), was higher in Asia than in Europe (coefficient 0.899, 95%CI: 0.809-0.999; p = 0.049). Among assessment methods, prevalence was highest in HAM-D scale (54%, 95%CI: 27-82%) and lowest in MINI (22%, 95%CI: 19-26%). Sensitivity analysis also corroborated findings when MINI was excluded (35%, 95%CI: 31-38%). CONCLUSIONS A significant proportion of PWE have depression. Though there is substantial heterogeneity due to various methodological moderators, it is unlikely to affect the routine screening of PWE for depression. Use of a screening tool should be based on ease of administration, and cutoff selection should ensure identification of minimal depression as well.
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Affiliation(s)
- Haroon Rashid
- Neuropharmacology Laboratory, Department of Pharmacology, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Ashish D Upadhyay
- Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Ravindra M Pandey
- Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Jatinder Katyal
- Neuropharmacology Laboratory, Department of Pharmacology, All India Institute of Medical Sciences, New Delhi 110029, India.
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Gonzalez‐Martinez A, Planchuelo‐Gómez Á, Vieira Campos A, Martínez‐Dubarbie F, Vivancos J, De Toledo‐Heras M. Medium-term changes in patients with epilepsy during the COVID-19 pandemic. Acta Neurol Scand 2021; 144:450-459. [PMID: 34195984 DOI: 10.1111/ane.13481] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/26/2021] [Accepted: 05/20/2021] [Indexed: 01/10/2023]
Abstract
OBJECTIVES The novel coronavirus disease (COVID-19) pandemic has led to social distancing measures and impaired medical care of chronic neurological diseases, including epilepsy, which may have adversely affected well-being and quality of life of patients with epilepsy (PWE). The objective of this study is to evaluate the impact of the COVID-19 pandemic in the levels of anxiety, depression, somnolence, and quality of life using validated scales in PWE in real-life clinical practice. MATERIALS & METHODS Self-administered scales of anxiety disorders (GAD-7), depression (NDDI-E), somnolence (Epworth Sleepiness Scale; ESS), and quality of life (QOLIE-31-P) in PWE treated in a Refractory Epilepsy Unit were longitudinally analyzed. Data were collected before the beginning (December 2019 - March 2020) and during the COVID-19 pandemic (September 2020-January 2021). RESULTS 158 patients (85 from the first round and 73 from the second round) 45.0 ± 17.3 years of age, 43.2% women, epilepsy duration 23.0 ± 14.9 years, number of antiepileptic drugs 2.1 ± 1.4, completed the survey. Significant longitudinal reduction of QOLIE-31-P (from 58.9 ± 19.7 to 56.2 ± 16.2, p = .035) and GAD-7 scores (from 8.8 ± 6.2 to 8.3 ± 5.9, corrected p = .024) was identified. No statistically significant longitudinal changes in the number of seizures (from 0.9 ± 1.9 to 2.5 ± 6.2, p = .125) or NDDI-E scores (from 12.3 ± 4.3 to 13.4 ± 4.4, p = .065) were found. Significant longitudinal increase of ESS (from 4.9 ± 3.7 to 7.4 ± 4.9, p = .001) was found. CONCLUSIONS During the COVID-19 pandemic, quality of life and anxiety levels were lower in PWE, and sleepiness levels were raised, without seizure change.
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Affiliation(s)
- Alicia Gonzalez‐Martinez
- Neurology Department Hospital Universitario de La Princesa & Instituto de Investigación Sanitaria La Princesa Madrid Spain
| | | | - Alba Vieira Campos
- Epilepsy Unit Neurology Department Hospital Universitario de La Princesa & Instituto de Investigación Sanitaria La Princesa Madrid Spain
| | | | - José Vivancos
- Neurology Department Hospital Universitario de La Princesa & Instituto de Investigación Sanitaria La Princesa Madrid Spain
| | - María De Toledo‐Heras
- Epilepsy Unit Neurology Department Hospital Universitario de La Princesa & Instituto de Investigación Sanitaria La Princesa Madrid Spain
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Perceived quality of life (QOLIE-31-P), depression (NDDI-E), anxiety (GAD-7), and insomnia in patients with epilepsy attended at a refractory epilepsy unit in real-life clinical practice. Neurol Sci 2021; 43:1955-1964. [PMID: 34524559 PMCID: PMC8440152 DOI: 10.1007/s10072-021-05595-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 09/06/2021] [Indexed: 11/26/2022]
Abstract
Objectives This study aims to evaluate the relationship between psychiatric comorbidity (anxiety and depression), somnolence, and quality of life, using validated scales in patients with epilepsy in real-life clinical practice and clinical and demographic variables. Methods A cross-sectional observational study was conducted. Self-administered scales of anxiety disorders (GAD-7), depression (NDDI-E), somnolence (Epworth Sleepiness Scale (ESS)), and quality of life (QOLIE-31-P) in patients with epilepsy treated in the refractory epilepsy unit of a tertiary hospital were employed. Results Eighty-four patients, 44.3 ± 17.4 years, 48.2% women, epilepsy duration 21.5 ± 15.9 years, and number of antiepileptic drugs 1.9 ± 1.2 were included. Severe anxiety was present in 14.3%, depression in 20.2%, and somnolence in 14.3% of patients. QOLIE-31-P score was 62.0 ± 19.2. Depression and focal epilepsy (OR = 4.5[1.3, 20.7], p = 0.029), as well as anxiety and temporal lobe epilepsy (OR = 4.3 [1.0, 18.1], p = 0.044), were associated. Moreover, relationships between worse quality of life and higher scores from NDDI-E (β = − 1.42, adjusted p = 0.006) and GAD-7 (β = − 1.21, adjusted p = 0.006), especially in drug-resistant epilepsy (β = − 8.08, adjusted p = 0.045) and female sex (β = − 7.83, adjusted p = 0.034), were identified. Statistically significant negative associations were observed between problems to fall asleep and overall quality of life score (β = − 11.64, adjusted p = 0.022), sleep disturbance and energy (β = − 14.78, adjusted p = 0.027), and mood (β = 12.40, adjusted p = 0.027) scores. Conclusions The multidimensional evaluation revealed that higher levels of anxiety and depression are associated with worse quality of life in real clinical practice in patients with epilepsy, especially in females and drug-resistant epilepsy. In addition, sleep disturbances are associated with particular aspects of the quality of life. Further studies with longitudinal follow-up would be useful to adequately manage these comorbidities in patients with epilepsy. Supplementary Information The online version contains supplementary material available at 10.1007/s10072-021-05595-3.
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Mireia G, Lara GL, Marta J, Marina HS, Alejandra F, Jordi C, Luis BJ, Laia GL. Clinical factors associated with work disability in epilepsy: A cross-sectional study at a tertiary referral hospital. Epilepsy Behav 2021; 124:108310. [PMID: 34530247 DOI: 10.1016/j.yebeh.2021.108310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 08/24/2021] [Accepted: 08/24/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The impact of epilepsy on work disability remains unclear. The aim of this study was to determine the percentage of patients with epilepsy who are unemployed or on temporary or permanent disability leave and to analyze associated clinical factors. METHODS We performed an observational cross-sectional study of consecutively recruited patients with epilepsy seen at a specialized epilepsy unit or admitted to the epilepsy monitoring unit of a tertiary referral hospital. We analyzed the percentage of patients who were actively employed, unemployed, and on temporary or permanent disability leave. The groups were compared for sociodemographic data (age, sex, marital status, and type of work), clinical data (type of epilepsy, disease duration, monthly seizure frequency, and presence of anxiety or depression), treatment-related factors, and quality of life. RESULTS We included 742 patients (53% male, mean age 44.3 ± 13.7 years old): 40.5% were employed, 29.2% were unemployed, 19% were on temporary disability leave, and 11.1% had a permanent work disability. Depressive symptoms and poorer quality of life were associated with unemployment (OR 2.3, p = 0.02 and OR 1.8, p = 0.01), temporary disability leave (OR 1.4, p = 0.05 and OR 1.7, p = 0.02), and permanent work disability (OR 1.9, p = 0.01 and OR 2.2, p = 0.01). Low-skilled work was also predictive of unemployment (OR 1.9, p = 0.04), temporary disability leave (OR 2.8, p = 0.03), and permanent work disability (OR 1.7, p = 0.04). A higher monthly seizure frequency was associated with permanent work disability (OR 2.01, p = 0.02). CONCLUSION Less than 50% of patients with epilepsy in our setting are working. Factors associated with unemployment and work disability are a higher frequency of seizures, low-skilled work, depressive symptoms, and poor quality of life.
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Affiliation(s)
- Gea Mireia
- Department of Neurosciences, Hospital Germans Trias I Pujol, C/ Canyet s/n, 08916 Badalona, Spain
| | - Grau-López Lara
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Jiménez Marta
- Department of Neurosciences, Hospital Germans Trias I Pujol, C/ Canyet s/n, 08916 Badalona, Spain
| | - Hernández-Stahl Marina
- Department of Neurosciences, Hospital Germans Trias I Pujol, C/ Canyet s/n, 08916 Badalona, Spain
| | - Fumanal Alejandra
- Department of Neurosciences, Hospital Germans Trias I Pujol, C/ Canyet s/n, 08916 Badalona, Spain
| | - Ciurans Jordi
- Department of Neurosciences, Hospital Germans Trias I Pujol, C/ Canyet s/n, 08916 Badalona, Spain
| | - Becerra Juan Luis
- Department of Neurosciences, Hospital Germans Trias I Pujol, C/ Canyet s/n, 08916 Badalona, Spain
| | - Grau-López Laia
- Department of Neurosciences, Hospital Germans Trias I Pujol, C/ Canyet s/n, 08916 Badalona, Spain.
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Sahebi Vaighan N, Delavar Kasmaei H, Hesami O, Azargashb E, Mohtasham Alsharieh A. Evaluation of reliability and validity of the Persian version of the Neurological Disorders Depression Inventory for Epilepsy (P-NDDI-E). Epilepsy Behav 2021; 114:107457. [PMID: 32994073 DOI: 10.1016/j.yebeh.2020.107457] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 08/31/2020] [Accepted: 08/31/2020] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Major depression is common among people with epilepsy (PWE), but it is underdiagnosed. The aim of the present study was to assess the reliability and validity of the Persian version of the Neurological Disorders Depression Inventory for Epilepsy (P-NDDI-E) as a screening tool for major depression in patients with epilepsy. METHOD A total of 210 patients suffering from epilepsy have been assessed using the NDDI-E and the Beck Depression Inventory-II (BDI-II) with no difficulty in understanding or answering the Persian version of the questionnaire. Patients identified as depressed under BDI-II underwent a psychiatric evaluation to confirm depression according to 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD) criteria. RESULT According to the BDI-II and the ICD-10 criteria, major depression was diagnosed in 75 patients (32% men, 68% women). Cronbach's α coefficient was 0.826, suggesting a very good internal consistency. The receiver operating characteristic analysis showed an area under the curve of 0.90 (95% confidence interval [CI] = 0.86-0.94, standard error [SE]: 0.02, p < 0.001). A cutoff of ≥14 resulted in an 83% sensitivity, an 80% specificity, a 70.1% positive predictive value, and an 88.6% negative predictive value. A significant and positive correlation between the P-NDDI-E and the BDI-II was shown (Spearman's ρ = 0.604, p < 0.001). DISCUSSION The P-NDDI-E could be used as a reliable and valid instrument in detecting major depression in PWE.
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Affiliation(s)
- Navideh Sahebi Vaighan
- Department of Neurology, Imam Hossein Medical and Educational Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hosein Delavar Kasmaei
- Department of Neurology, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Omid Hesami
- Department of Neurology, Imam Hossein Medical and Educational Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Eznollah Azargashb
- Department of Social Medicine, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Mohtasham Alsharieh
- Department of Psychiatry, Imam Hossein Medical and Educational Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Gutiérrez-Viedma Á, Sanz-Graciani I, Romeral-Jiménez M, Parejo-Carbonell B, Serrano-García I, Cuadrado ML, Aledo-Serrano Á, Gil-Nagel A, Toledano R, Pérez-De-Heredia-Torres M, Santamarina E, García-Morales I. Epidaily, a scale for comprehensive functional assessment of patients with epilepsy. Epilepsy Behav 2021; 114:107570. [PMID: 33234457 DOI: 10.1016/j.yebeh.2020.107570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 10/19/2020] [Accepted: 10/19/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To develop and validate an epilepsy-specific scale for comprehensive functional assessment of patients with epilepsy, named Epidaily. METHODS The multidisciplinary research group created through brainstorming a list of 47 items to explore the cognitive, social, basic and instrumental functionality of the patient. A group of epilepsy experts independent of the research group evaluated the suitability of all the items, which then were selected and reviewed by the research group to conform the Epidaily scale. On a sample of 102 patients, a reliability analysis was performed, as well as a validation one using as reference scale the score on the Activities of Daily Living Questionnaire (ADLQ), which evaluates basic and instrumental functionality. RESULTS Epidaily consisted of 10 items distributed in four dimensions, with a possible score from 0 to 100 (perfect functionality). Inter-observer reliability was excellent, with an intraclass correlation coefficient of 0.98 (95% confidence interval 0.97-0.99). Criterion validity was demonstrated by the high positive correlation of the Epidaily score with the ADLQ score (Spearman's rho coefficient 0.85, p < 0.001). Significant relation was found between ADLQ and Epidaily in the linear regression analysis (p < 001), which reported that Epidaily explains 85.5% of the variability of ADLQ (R-squared 0.85). Discriminant validity was also proved, as Epidaily allowed to classify epilepsy severity based on Cramer et al epilepsy severity classification. The median time to obtain the Epidaily score was 5 min (interquartile range 4-6). SIGNIFICANCE Epidaily is a brief and versatile scale, with excellent inter-observer reliability, which has been validated for comprehensive functional assessment of patients with epilepsy.
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Affiliation(s)
- Álvaro Gutiérrez-Viedma
- Unidad de Epilepsia, Servicio de Neurología, Hospital Clínico San Carlos, Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain; Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Plaza de Ramón y Cajal s/n, 28040 Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain; Servicio de Neurología, Hospital Universitario Fundación Jiménez Díaz, Avenida de los Reyes Católicos 2, 28040 Madrid, Spain; Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina física, Facultad de Ciencias de la Salud , Universidad Rey Juan Carlos, Avenida de Atenas s/n, 28922 Alcorcón, Madrid, Spain.
| | - Isabel Sanz-Graciani
- Unidad de Epilepsia, Servicio de Neurología, Hospital Clínico San Carlos, Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain; Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina física, Facultad de Ciencias de la Salud , Universidad Rey Juan Carlos, Avenida de Atenas s/n, 28922 Alcorcón, Madrid, Spain
| | - María Romeral-Jiménez
- Unidad de Epilepsia, Servicio de Neurología, Hospital Clínico San Carlos, Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain; Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina física, Facultad de Ciencias de la Salud , Universidad Rey Juan Carlos, Avenida de Atenas s/n, 28922 Alcorcón, Madrid, Spain
| | - Beatriz Parejo-Carbonell
- Unidad de Epilepsia, Servicio de Neurología, Hospital Clínico San Carlos, Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain; Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina física, Facultad de Ciencias de la Salud , Universidad Rey Juan Carlos, Avenida de Atenas s/n, 28922 Alcorcón, Madrid, Spain
| | - Irene Serrano-García
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain; Unidad de Metodología de Investigación y Epidemiología Clínica, Servicio de Medicina Preventiva, Hospital Clínico San Carlos, Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain; Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina física, Facultad de Ciencias de la Salud , Universidad Rey Juan Carlos, Avenida de Atenas s/n, 28922 Alcorcón, Madrid, Spain
| | - María-Luz Cuadrado
- Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Plaza de Ramón y Cajal s/n, 28040 Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain; Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina física, Facultad de Ciencias de la Salud , Universidad Rey Juan Carlos, Avenida de Atenas s/n, 28922 Alcorcón, Madrid, Spain
| | - Ángel Aledo-Serrano
- Programa de Epilepsia, Servicio de Neurología, Hospital Ruber Internacional, Calle La Masó 38, 28034 Madrid, Spain; Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina física, Facultad de Ciencias de la Salud , Universidad Rey Juan Carlos, Avenida de Atenas s/n, 28922 Alcorcón, Madrid, Spain
| | - Antonio Gil-Nagel
- Programa de Epilepsia, Servicio de Neurología, Hospital Ruber Internacional, Calle La Masó 38, 28034 Madrid, Spain; Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina física, Facultad de Ciencias de la Salud , Universidad Rey Juan Carlos, Avenida de Atenas s/n, 28922 Alcorcón, Madrid, Spain
| | - Rafael Toledano
- Programa de Epilepsia, Servicio de Neurología, Hospital Ruber Internacional, Calle La Masó 38, 28034 Madrid, Spain; Unidad de Epilepsia, Servicio de Neurología, Hospital Ramón y Cajal, Carretera de Colmenar Viejo 100, 28034 Madrid, Spain; Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina física, Facultad de Ciencias de la Salud , Universidad Rey Juan Carlos, Avenida de Atenas s/n, 28922 Alcorcón, Madrid, Spain
| | - Marta Pérez-De-Heredia-Torres
- Unidad de Epilepsia, Servicio de Neurología, Hospital Ramón y Cajal, Carretera de Colmenar Viejo 100, 28034 Madrid, Spain; Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina física, Facultad de Ciencias de la Salud , Universidad Rey Juan Carlos, Avenida de Atenas s/n, 28922 Alcorcón, Madrid, Spain
| | - Estevo Santamarina
- Unidad de Epilepsia, Servicio de Neurología, Hospital Vall D́Hebrón, Passeig de la Vall d'Hebron, 119, 08035 Barcelona, Spain; Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina física, Facultad de Ciencias de la Salud , Universidad Rey Juan Carlos, Avenida de Atenas s/n, 28922 Alcorcón, Madrid, Spain
| | - Irene García-Morales
- Unidad de Epilepsia, Servicio de Neurología, Hospital Clínico San Carlos, Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain; Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Plaza de Ramón y Cajal s/n, 28040 Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain; Programa de Epilepsia, Servicio de Neurología, Hospital Ruber Internacional, Calle La Masó 38, 28034 Madrid, Spain; Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina física, Facultad de Ciencias de la Salud , Universidad Rey Juan Carlos, Avenida de Atenas s/n, 28922 Alcorcón, Madrid, Spain
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Validation of the Russian version of neurological disorders depression inventory for epilepsy (NDDI-E). Epilepsy Behav 2020; 113:107549. [PMID: 33246233 DOI: 10.1016/j.yebeh.2020.107549] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/25/2020] [Accepted: 09/28/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To translate and validate the English version of the Neurologic Depression Disorders Inventory in Epilepsy (NDDI-E) into the Russian language as an instrument for rapid detection of major depressive episodes (MDE) for patients with epilepsy (PWE) from Russian Federation. METHODS One hundred and 75 consecutive PWE were included in the study. All patients were assessed with Mini-International Neuropsychiatric Interview (MINI 6.0.0), Hospital Anxiety and Depression Scale (HADS) and the Russian version of NDDI-E. Chi-square, Fisher's exact and Mann-Whitney tests were used to compare PWE with and without MDE. We analyzed internal structural validity, external validity, and receiver operator characteristics. RESULTS None of the participants had any difficulties in understanding the questions of NDDI-E. The internal consistency of the inventory was satisfactory (Cronbach's ά = 0.856). Correlation between the NDDI-E and the HADS scores was moderate (r = 0.64, P < 0.001), indicating acceptable external validity. NDDI showed good capacity to detect MDE, with area under the curve of 0.919 (95% CI = 0.868-0.955; standard error: 0.019; P < 0.001). An optimal cut-off point with the highest Yuden's index (J = 0.699) was > 12. At this point NDDI-E showed sensitivity of 88.16% (95% CI = 78.7%-94.4%), specificity of 81.82% (95% CI = 72.8%-88.9%), positive predictive value of 59.3% (95% CI = 48.8%-69.0%), negative predictive value of 95.8% (95% CI = 92.5%-97.7%). CONCLUSION Russian version of NDDI-E is an affordable and fast screening tool with a good combination of sensitivity and specificity.
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Shih YC, Chou CC, Lu YJ, Chou YH, Yu HY. Reliability and validity of the Taiwanese version of the Neurological Disorders Depression Inventory for Epilepsy (Tw-NDDI-E). Seizure 2020; 81:53-57. [PMID: 32745948 DOI: 10.1016/j.seizure.2020.07.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 07/19/2020] [Accepted: 07/24/2020] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION Depression is the most commonly seen psychiatric co-morbidity of epilepsy. Depression in patients with epilepsy (PWE) is underrecognized. The Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) is a useful tool to screen for major depressive episodes (MDEs) in PWE. This study validated the Taiwanese version of the NDDI-E using data from adult PWE in our hospital. METHOD PWE were recruited from the Taipei Veterans General Hospital from April 2017 to December 2019. The Chinese version of the NDDI-E for the Taiwanese population and the Beck Depression Inventory-II (BDI-II) were completed as part of the self-rated psychiatric assessments. The mood disorder module of the Mini International Neuropsychiatric Interview (MINI) was completed as part of the psychiatric assessment before the self-rated assessment. Internal consistency, external validation, and receiver operator characteristic (ROC) curve analysis were used to assess the utility of the Taiwanese version of the NDDI-E. RESULTS We recruited 109 patients during the 33-month study period. The mean age was 33.1 ± 8.94 years old. The mean NDDI-E score was 12.32 ± 4.96. The mean BDI-II score was 13.26 ± 12.77. All NDDI-E items were significantly positively associated with the corrected overall NDDI-E score (Cronbach's alpha = 0.902, r = 0.825, p < 0.0001). The cut-off point for the NDDI-E determined with receiver operating characteristic (ROC) curve analysis is 15 (sensitivity = 85.0%, specificity = 87.64%). CONCLUSION The Chinese version of the NDDI-E adapted for the Taiwanese population is a reliable and valid self-reported questionnaire for detecting MDE in Taiwanese PWE.
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Affiliation(s)
- Yen-Cheng Shih
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan; Brain Research Centre, National Yang-Ming University, Taipei, Taiwan
| | - Chien-Chen Chou
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan; Brain Research Centre, National Yang-Ming University, Taipei, Taiwan
| | - Yi-Jiun Lu
- Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yuan-Hwa Chou
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - Hsiang-Yu Yu
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan; Brain Research Centre, National Yang-Ming University, Taipei, Taiwan.
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Comparison of the performance of two depression rating scales in patients with epilepsy in southern China. Epilepsy Behav 2020; 106:107025. [PMID: 32199345 DOI: 10.1016/j.yebeh.2020.107025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 03/02/2020] [Accepted: 03/03/2020] [Indexed: 01/04/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate and compare the performance of the Chinese version of the Neurological Disorder Depression Inventory for Epilepsy (CNDDI-E) with that of the depression subscale of the Hospital Anxiety and Depression Scale (C-HADS-D) as screening tools for depression in the same patients with epilepsy (PWE). METHODS A total of 213 consecutive PWE were evaluated. Receiver operating characteristic (ROC) analysis was performed using the C-NDDI-E and C-HADS-D as predictors and the Chinese version of the Mini International Neuropsychiatric Interview (C-MINI) as the gold standard. RESULTS The area under the curve (AUC) for the C-NDDI-E was 0.870, and the optimal cutoff score was >11 (sensitivity 85.71%, specificity 79.78%); for the C-HADS-D, the AUC was 0.804, and the optimal cutoff score was >5 (sensitivity 85.71%, specificity 62.36%). The AUC for the C-NDDI-E was larger than the AUC for the C-HADS-D, but the comparison of the AUCs revealed no significant differences (P = 0.1444). CONCLUSION Our findings indicate that the C-NDDI-E and C-HADS-D have high validity and support the use of these screening tools for depression in PWE. Moreover, the C-NDDI-E is a better screening scale for diagnosing depression than the C-HADS-D according to the results of this study.
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Zapata Barco AM, Restrepo-Martínez M, Restrepo D. Depression in People with Epilepsy. What is the Connection? REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2020; 49:53-61. [PMID: 32081210 DOI: 10.1016/j.rcp.2017.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 08/25/2017] [Accepted: 10/22/2017] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Depression is the most common psychiatric comorbidity in people with epilepsy. It worsens the prognosis and quality of life of these patients. Despite this, depression is poorly diagnosed and when the treatment is given, it is frequently suboptimal. OBJECTIVE To perform a narrative review of the medical literature, seeking to collect useful information regarding the relationship between epilepsy and depression. RESULTS Narrative reviews, systematic reviews, meta-analyses, clinical trials, and follow-up studies were identified in English and Spanish with no time limit, including epidemiological, clinical, associated factors, etiological explanations, diagnostic and therapeutic approaches to comorbid depression in epilepsy. CONCLUSION The relationship between epilepsy and depression is complex. The available scientific evidence suggests the possibility of a bidirectional relationship that could be explained from common aetiopathogenic mechanisms. Despite the high prevalence of depression in epileptic patients, this mental disorder continues to be poorly identified by clinicians. To improve this, we have easy-to-apply instruments that routinely screen this patient population and contribute substantially to making the problem more visible and seek to improve the quality of life for this population.
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Manzanares I, Sevilla Guerra S, Lombraña M, Gil-López F, Conde-Blanco E, Zabalegui A, Pfäfflin M, May TW, Kostov B, Moreno-Poyato A, Donaire A, Guio L, Beltran O, Cuzco C, Carreño M. Spanish version of the Satisfaction with Epilepsy Care questionnaire: Adaptation and psychometric properties. Epilepsy Behav 2020; 102:106812. [PMID: 31830723 DOI: 10.1016/j.yebeh.2019.106812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 11/14/2019] [Accepted: 11/19/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The objective of this study was to perform a cross-cultural adaption and psychometric evaluation of the Spanish version of the Satisfaction with Epilepsy Care (SEC) questionnaire and analyze patient satisfaction with epilepsy care. METHODS Transcultural adaptation and validation of the SEC were carried out using translation and back-translation with pilot testing and an expert panel. The SEC-E (Spanish) was analyzed in 213 patients with epilepsy to examine construct and criterion validity and internal consistency. RESULTS The SEC-E achieved conceptual, semantic, and content equivalence with the original version. For content validity, one question was eliminated from the original questionnaire as it has little relevance in our cultural setting. Positive correlations for criterion validity were obtained using the gold standard measure (Satisfaction in Hospitalized Patients scale). Construct validity replicated the three dimensions of the original questionnaire. The scale showed adequate reliability through internal consistency (Cronbach's α of 0.94) and temporal stability on retest (n = 85). Patients scored (0 to 100) 77.5 [standard deviation (SD): 19.9] for satisfaction with communication, 76.9 (SD: 17) for organization, and 67.2 (SD: 22.1) for information. SIGNIFICANCE The SEC-E is a valid and reliable tool for the assessment of educational interventions aiming to improve the quality of care in patients with epilepsy in Spanish clinical practice. The results showed a good level of patient satisfaction with epilepsy care.
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Affiliation(s)
- Isabel Manzanares
- Epilepsy Unit, Department of Neurology, Hospital Clínic de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
| | - Sonia Sevilla Guerra
- Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Nursing Direction, Hospital Clínic de Barcelona, Spain
| | - María Lombraña
- Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Nursing Direction, Hospital Clínic de Barcelona, Spain
| | - Francisco Gil-López
- Epilepsy Unit, Department of Neurology, Hospital Clínic de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Estefanía Conde-Blanco
- Epilepsy Unit, Department of Neurology, Hospital Clínic de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Adelaida Zabalegui
- Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Nursing Direction, Hospital Clínic de Barcelona, Spain
| | - Margarete Pfäfflin
- Society for Epilepsy Research, Epilepsy Center Bethel, Bielefeld, Germany
| | - Theordor W May
- Society for Epilepsy Research, Epilepsy Center Bethel, Bielefeld, Germany
| | - Belchin Kostov
- Primary Healthcare Transversal Research Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Antonio Moreno-Poyato
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, Nursing School, University of Barcelona, Spain
| | - Antonio Donaire
- Epilepsy Unit, Department of Neurology, Hospital Clínic de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Laura Guio
- Epilepsy Unit, Department of Neurology, Hospital Clínic de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Olga Beltran
- Epilepsy Unit, Department of Neurology, Hospital Clínic de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Cecilia Cuzco
- Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Mar Carreño
- Epilepsy Unit, Department of Neurology, Hospital Clínic de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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Silagadze K, Kasradze S, Silagadze T, Lomidze G. Validation of a Georgian version of the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E). Epilepsy Behav 2019; 101:106587. [PMID: 31698261 DOI: 10.1016/j.yebeh.2019.106587] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 09/20/2019] [Accepted: 09/20/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION This study aimed to validate a Georgian version of the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E). The distribution of psychiatric disorders was assessed among patients with epilepsy. METHODS One hundred and thirty consecutive adult patients with epilepsy completed the NDDI-E and the Beck Depression Inventory (BDI). All patients were further assessed by a qualified psychiatrist. RESULTS In 31 (23.8%) patients, a diagnosis of major depression was revealed. The internal consistency of the NDDI-E was 0.695. Receiver operating characteristics (ROC) showed an area under the curve of 0.975. A cutoff score of ≥16 resulted in a sensitivity of 0.90 and a specificity of 0.939. The screening questionnaire showed a significantly positive correlation with BDI scores (Spearman's rho - 0.684), indicating good concurrent validity. DISCUSSION The Georgian version of the NDDI-E is a reliable tool for the detection of depressive disorders in individuals with epilepsy.
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Affiliation(s)
- Ketevan Silagadze
- Institute of Neurology and Neuropsychology, 83/11 Vaja-Pshavela Ave., 0186 Tbilisi, Georgia; Tbilisi State Medical University, 33 Vaja-Pshavela Ave., 0186 Tbilisi, Georgia
| | - Sofia Kasradze
- Caucasus International University, 73 Chargali Str., 0141 Tbilisi, Georgia; Institute of Neurology and Neuropsychology, 83/11 Vaja-Pshavela Ave., 0186 Tbilisi, Georgia
| | - Teimuraz Silagadze
- Tbilisi State Medical University, 33 Vaja-Pshavela Ave., 0186 Tbilisi, Georgia
| | - Giorgi Lomidze
- Caucasus International University, 73 Chargali Str., 0141 Tbilisi, Georgia; Institute of Neurology and Neuropsychology, 83/11 Vaja-Pshavela Ave., 0186 Tbilisi, Georgia.
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Gutiérrez-Viedma Á, Sanz-Graciani I, Romeral-Jiménez M, Parejo-Carbonell B, Serrano-García I, Cuadrado ML, Aledo-Serrano Á, Gil-Nagel A, Toledano R, García-Morales I. Patients' knowledge on epilepsy and SUDEP improves after a semi-structured health interview. Epilepsy Behav 2019; 99:106467. [PMID: 31421520 DOI: 10.1016/j.yebeh.2019.106467] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 07/25/2019] [Accepted: 07/29/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Patients' education is the most relevant contributor to patient self-management of epilepsy. We aimed to assess the acquisition of knowledge after a semi-structured interview. METHODS We performed a quasi-experimental prospective study with a cohort of patients with epilepsy admitted for prolonged video electroencephalogram (VEEG). We measured patients' baseline knowledge with a 10-item true-false test (test A). Then, a qualified nurse carried out a semi-structured interview. We measured acquired knowledge with another 10-item true-false exam (test B), prior to VEEG discharge and after a 3- to 5-month follow-up, and we compared the difference between the scores in test A and test B. Finally, we conducted a satisfaction and suitability survey on the interview at follow-up. RESULTS Thirty-two patients participated, half were women. Their median age was 39.5, and the median length of schooling was 14 years. The median time since epilepsy onset was 13 years, 75% had suffered tonic-clonic seizures. The median score on test A was 7, while the median score on test B was 8.5 (p < 0.001) both at VEEG discharge and after follow-up. After the interview, 84.4% of participants reported that they were very satisfied with the information received; 87.5% stated that they had not previously heard about SUDEP (sudden unexpected dead in epilepsy); and 93.8% considered it important to receive detailed information about SUDEP. CONCLUSIONS Patient education through a semi-structured comprehensive interview improves knowledge of patients with epilepsy about their disease. The calm atmosphere and the qualified nursing working at VEEG units make them an appropriate setting for talking about epilepsy and its risks, including SUDEP.
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Affiliation(s)
- Álvaro Gutiérrez-Viedma
- Unidad de Epilepsia, Servicio de Neurología, Hospital Clínico San Carlos, Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain; Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Plaza de Ramón y Cajal s/n, 28040 Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain.
| | - Isabel Sanz-Graciani
- Unidad de Epilepsia, Servicio de Neurología, Hospital Clínico San Carlos, Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain
| | - María Romeral-Jiménez
- Unidad de Epilepsia, Servicio de Neurología, Hospital Clínico San Carlos, Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain
| | - Beatriz Parejo-Carbonell
- Unidad de Epilepsia, Servicio de Neurología, Hospital Clínico San Carlos, Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain
| | - Irene Serrano-García
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain; Unidad de Metodología de Investigación y Epidemiología Clínica, Servicio de Medicina Preventiva, Hospital Clínico San Carlos, Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain
| | - María-Luz Cuadrado
- Unidad de Epilepsia, Servicio de Neurología, Hospital Clínico San Carlos, Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain; Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Plaza de Ramón y Cajal s/n, 28040 Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain
| | - Ángel Aledo-Serrano
- Unidad de Epilepsia, Servicio de Neurología, Hospital Ruber Internacional, Calle La Masó 38, 28034 Madrid, Spain
| | - Antonio Gil-Nagel
- Unidad de Epilepsia, Servicio de Neurología, Hospital Ruber Internacional, Calle La Masó 38, 28034 Madrid, Spain
| | - Rafael Toledano
- Unidad de Epilepsia, Servicio de Neurología, Hospital Ruber Internacional, Calle La Masó 38, 28034 Madrid, Spain; Unidad de Epilepsia, Servicio de Neurología, Hospital Ramón y Cajal, Carretera de Colmenar Viejo 100, 28034 Madrid, Spain
| | - Irene García-Morales
- Unidad de Epilepsia, Servicio de Neurología, Hospital Clínico San Carlos, Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain; Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Plaza de Ramón y Cajal s/n, 28040 Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain; Unidad de Epilepsia, Servicio de Neurología, Hospital Ruber Internacional, Calle La Masó 38, 28034 Madrid, Spain
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Cengiz GF, Tanık N. Validity and reliability of the Turkish version of the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E). Epilepsy Behav 2019; 99:106471. [PMID: 31461680 DOI: 10.1016/j.yebeh.2019.106471] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 07/19/2019] [Accepted: 07/26/2019] [Indexed: 11/19/2022]
Abstract
The aim of this study was to test the validity and reliability of the Turkish version of the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), which was developed to rapidly investigate depressive symptoms in patients with epilepsy. A consecutive sample of 51 patients with epilepsy was included in the study. The Beck Depression Inventory (BDI) and the Turkish version of the NDDI-E were applied to the participants. During the application, it was observed that the participants could quickly fill the scale without any difficulties in understanding the translated items. The Cronbach's α coefficient was 0.721. Receiver operating characteristic analysis showed an area under the curve of 0.902 (95% confidence interval [CI] = 0.822-0.983), a cutoff score of >15, a sensitivity of 88.2%, a specificity of 82.4%, a positive predictive value of 71.4%, a negative predictive value of 93.3%. The NDDI-E Turkish version scores were significantly and positively correlated with those of the BDI (Spearman's ρ = 0.832, p < 0.001). In conclusion, it has been determined that the Turkish version of the NDDI-E can be used as a valid and reliable measurement tool to detect major depression in Turkish people with epilepsy.
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Affiliation(s)
- Gül Ferda Cengiz
- Bozok University School of Medicine, Department of Psychiatry, Yozgat, Turkey.
| | - Nermin Tanık
- Bozok University School of Medicine, Department of Neurology, Yozgat, Turkey
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Rashid H, Katyal J, Tripathi M, Sood M, Gupta YK. Validation of the Indian version of Neurological Disorders Depression Inventory for Epilepsy (NDDI-E). Epilepsy Behav 2019; 95:75-78. [PMID: 31026787 DOI: 10.1016/j.yebeh.2019.03.048] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 03/28/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE The Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) is an efficient tool for rapid detection of depression, an important comorbid condition in persons with epilepsy (PWE). Since social and cultural differences can potentially affect the cutoff score of NDDI-E, in this study, the reliability and validity of the Indian version of the NDDI-E in PWE was determined. METHOD After ethical clearance, 217 PWE above 18 years of age, on antiepileptic drugs (AEDs), attending neurology outpatient department (OPD) of All India Institute of Medical Sciences (AIIMS), New Delhi, India, were evaluated for depression using the NDDI-E (Indian version) and Mini International Neuropsychiatric Interview (MINI-Module A, version 6.0.0) as reference standard. Informed consent was taken before recruitment. Receiver operating characteristic (ROC) analysis and Cronbach's α, a measure of the internal consistency and reliability, were carried out to validate cutoff and questionnaire, respectively. RESULTS Of the 217 PWE (112 males/105 females), mean age of 28.6 ± 9.4 years, with generalized (69.1%) or focal seizures (30.9%), 41.5% and 10.6% were diagnosed with depression using MINI and NDDI-E Indian version (at cutoff >15), respectively. However, at a cutoff score of >11, the Indian version of NDDI-E had a sensitivity of 96.67%, a specificity of 84.25%, a positive predictive value of 81.31%, and a negative predictive value of 97.27%. ROC analysis showed an area under the curve (AUC) of 0.9547 (confidence interval (CI) 95% = 0.929-0.979; standard error (SE): 0.0127). With the Indian version of NDDI-E, the Cronbach's α value was 0.877. CONCLUSION A periodic assessment of PWE using a quickly administrable and reliable tool for screening depression is highly desirable given the high incidence. In the Indian population with a cutoff of >11, NDDI-E is a reliable and valid instrument to screen depression in PWE.
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Affiliation(s)
- Haroon Rashid
- Neuropharmacology Laboratory, Department of Pharmacology, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Jatinder Katyal
- Neuropharmacology Laboratory, Department of Pharmacology, All India Institute of Medical Sciences, New Delhi 110029, India.
| | - Manjari Tripathi
- Department of Neurology, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Mamta Sood
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Yogendra K Gupta
- Translational Health Science and Technology Institute, Faridabad, Haryana, India
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Li Q, Zhu LN, Wang HJ, Lin X, Xu D, Chen D, Zhang Y, Liu L. Validation of the Neurological Disorders Depression Inventory for Epilepsy (NDDIE) as a rapid suicidality screening tool in Chinese people with epilepsy. Epilepsy Behav 2019; 94:216-221. [PMID: 30974350 DOI: 10.1016/j.yebeh.2019.03.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 03/17/2019] [Accepted: 03/17/2019] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The objective of this study was to validate the Chinese version of the Neurological Disorders Depression Inventory for Epilepsy (NDDIE) as a suicidality screening tool in Chinese people with epilepsy (PWE). METHODS A consecutive cohort of PWE was recruited from West China Hospital and 363 Hospital. Each patient received a psychiatric evaluation with the Mini International Neuropsychiatric Interview (MINI) and the Chinese version of the NDDIE (C-NDDIE). Demographic and clinical characteristics were collected. Receiver operating characteristic (ROC) curve analysis was conducted. The best possible cutoff was identified with the highest Youden index. Specificity, sensitivity, positive, and negative predictive values were calculated. RESULTS Among a total of 355 participants, 41 (11.5%) had a moderate to high suicide risk according to the Suicidality Module (SM) of the MINI. Receiver operating characteristic (ROC) curve analysis showed that item 4 ("I'd be better off dead") of the NDDIE had an area under the curve (AUC) of 0.930 (95% confidence interval [CI] = 0.884-0.977), a sensitivity of 80.5%, a specificity of 94.9%, a positive predictive value (PPV) of 68.0%, a negative predictive value (NPV) of 97.7%, and the largest Youden index of 0.754 for a cutoff score of >2. CONCLUSION Item 4 of the NDDIE is a valuable tool for screening suicidality in Chinese PWE.
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Affiliation(s)
- Qian Li
- Department of Neurology, West China Hospital, Sichuan University, Wai Nan Guo Xue Lane 37#, Chengdu, Sichuan 610041, China; Department of Neurology, 363 Hospital, Daosangshu Road 108#, Chengdu, Sichuan 610041, China
| | - Li-Na Zhu
- Department of Neurology, West China Hospital, Sichuan University, Wai Nan Guo Xue Lane 37#, Chengdu, Sichuan 610041, China
| | - Hai-Jiao Wang
- Department of Neurology, West China Hospital, Sichuan University, Wai Nan Guo Xue Lane 37#, Chengdu, Sichuan 610041, China
| | - Xu Lin
- Department of Neurology, 363 Hospital, Daosangshu Road 108#, Chengdu, Sichuan 610041, China
| | - Da Xu
- Department of Neurology, West China Hospital, Sichuan University, Wai Nan Guo Xue Lane 37#, Chengdu, Sichuan 610041, China
| | - Deng Chen
- Department of Neurology, West China Hospital, Sichuan University, Wai Nan Guo Xue Lane 37#, Chengdu, Sichuan 610041, China
| | - Yu Zhang
- Department of Neurology, West China Hospital, Sichuan University, Wai Nan Guo Xue Lane 37#, Chengdu, Sichuan 610041, China
| | - Ling Liu
- Department of Neurology, West China Hospital, Sichuan University, Wai Nan Guo Xue Lane 37#, Chengdu, Sichuan 610041, China.
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Kim DH, Kim YS, Yang TW, Kwon OY. Optimal cutoff score of the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) for detecting major depressive disorder: A meta-analysis. Epilepsy Behav 2019; 92:61-70. [PMID: 30616067 DOI: 10.1016/j.yebeh.2018.12.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 12/09/2018] [Accepted: 12/09/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND PURPOSE The Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) is a useful inventory for screening major depressive disorder (MDD) in people with epilepsy (PWE). The cutoff score for detecting MDD has been reported with the range of >11 to >16. The aim of this study was to find optimal cutoff score of the NDDI-E for MDD detection by combining the raw data from previous studies. METHODS We searched MEDLINE, EMBASE, Cochrane Library, Web of Science, and SCOPUS to identify proper studies. Original researches, which tested the accuracy of NDDI-E for MDD detection in adult PWE, were recruited. We included the studies in which MDD was diagnosed by a gold standard structural interview, the Mini International Neuropsychiatric Interview (MINI). In addition, we included only the studies providing enough information for meta-analysis: number of PWE with MDD, number of total PWE, and sensitivity (Se) and specificity (Spe) for each cutoff score. After collecting data from included studies, we performed a diagnostic test accuracy (DTA) meta-analysis using bivariate model. RESULTS We identified 13 validation studies conducted in outpatient epilepsy clinic setting. As summary estimates of test accuracy measures, the Se, Spe, and diagnostic odds ratio (DOR) of NDDI-E for MDD detection were 0.81, 0.84, and 22.48, respectively. The analysis using the multiple thresholds model showed that the NDDI-E score of 13.2 was the best fit for MDD detection. When analyzing only with the seven data sets of the cutoff score >13, the Se, Spe, and DOR were 0.87, 0.80, and 25.72, respectively. CONCLUSIONS The optimal NDDI-E cutoff score for MDD detection is >13. The information provided by this DTA meta-analysis will be a useful reference for applying NDDI-E in geographic areas where no NDDI-E validation studies have been conducted for their languages.
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Affiliation(s)
- Do-Hyung Kim
- Department of Neurology and Institute of Health Science, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Young-Soo Kim
- Department of Neurology and Institute of Health Science, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Tae-Won Yang
- Department of Neurology and Institute of Health Science, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Oh-Young Kwon
- Department of Neurology and Institute of Health Science, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea.
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Lin J, Wang X, Dong F, Du Y, Shen J, Ding S, Wang L, Ye M, Wang Y, Xia N, Zheng R, Chen H, Xu H. Validation of the Chinese version of the Hamilton Rating Scale for Depression in adults with epilepsy. Epilepsy Behav 2018; 89:148-152. [PMID: 30415137 DOI: 10.1016/j.yebeh.2018.10.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 10/06/2018] [Accepted: 10/07/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE This study aimed to validate the Chinese version of the 17-item Hamilton Rating Scale for Depression (C-HRSD-17) for use in adult patients with epilepsy (PWE). METHODS A consecutive sample of Chinese adult PWE from a tertiary hospital was examined using the C-HRSD-17 and the Mini International Neuropsychiatric Interview (MINI) Plus Chinese Version 5.0.0. RESULTS A total of 191 PWE completed the assessment of depression. According to the MINI, thirty patients (15.7%) had current major depressive disorder (MDD). The Cronbach's α coefficient for the C-HRSD-17 was 0.832. Receiver operating characteristic (ROC) analysis showed an area under the curve (AUC) of 0.983 (95% CI = 0.968-0.998). With a cutoff score of 9, the C-HRSD-17 demonstrated the best psychometric properties, with a sensitivity of 96.7%, a specificity of 93.8%, a positive predictive value (PPV) of 74.4%, and a negative predictive value (NPV) of 99.3%. CONCLUSION The C-HRSD-17 proved to be a valid and reliable assessment tool, with a cutoff score of 9 for screening of current MDD in Chinese adult PWE.
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Affiliation(s)
- Jiahe Lin
- Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, PR China
| | - Xinshi Wang
- Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, PR China
| | - Feirong Dong
- Department of Psychiatry, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, PR China
| | - Yanru Du
- Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, PR China
| | - Jingzan Shen
- Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, PR China
| | - Siqi Ding
- Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, PR China
| | - Li Wang
- Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, PR China
| | - Mengqian Ye
- Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, PR China
| | - Yi Wang
- Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, Wenzhou, Zhejiang Province, PR China
| | - Niange Xia
- Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, PR China
| | - Rongyuan Zheng
- Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, PR China
| | - Hong Chen
- Department of Psychiatry, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, PR China
| | - Huiqin Xu
- Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, PR China.
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Abarrategui B, Parejo-Carbonell B, García García ME, Di Capua D, García-Morales I. The cognitive phenotype of idiopathic generalized epilepsy. Epilepsy Behav 2018; 89:99-104. [PMID: 30408705 DOI: 10.1016/j.yebeh.2018.10.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 10/07/2018] [Accepted: 10/07/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Dysexecutive traits have been described in idiopathic generalized epilepsy (IGE), but studies mainly focused on juvenile myoclonic epilepsy (JME). To better understand the neuropsychology of IGE, more research is needed on syndromes other than JME, controlling potential confounding factors as the cognitive effects of valproate and epileptic discharges (ED). We describe the neuropsychological profile of a group of patients with different syndromes of IGE including simultaneous video electroencephalography (EEG). METHODS We performed a comprehensive cognitive and neuropsychiatric evaluation with video-EEG on 61 adults with IGE (JME 19; IGE with generalized tonic-clonic seizures [GTCS] alone [IGE-GTCS] 22; childhood absence epilepsy [CAE] or juvenile absences epilepsy [JAE] persisting in adulthood 20). We compared results between patients (globally and by syndrome) and a control group of 21 individuals (similar age, educational level); p-values were adjusted for multiple testing according to a 0.05 false discovery rate. RESULTS Patients obtained significantly lower results than controls on visuospatial working memory, processing speed, cognitive flexibility and strategy, abstract visuospatial reasoning, arithmetic, and acquired knowledge. While CAE/JAE showed the lowest scores on cognitive assessment and highest anxiety index, IGE-GTCS showed the most favorable scores. Most tests were not influenced by valproate intake, and the dose did not correlate with cognitive performance in the test that yielded differences between patients and controls. Epileptic discharges during assessment were not frequent (10 patients, 1-4 tests). SIGNIFICANCE Our findings suggest that patients with IGE have significantly lower abilities in various executive functions and acquired knowledge, compared to population of same age and education. The low frequency of ED on simultaneous video-EEG and absence of correlation of scores with valproate dose reinforce that the obtained results are due to a cognitive phenotype in IGE. This phenotype may be influenced by syndrome, and patients with CAE/JAE persisting in the adult may have a wider neuropsychiatric impairment.
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Affiliation(s)
- Belén Abarrategui
- Unidad de Epilepsia, Hospital Clínico San Carlos, Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain.
| | - Beatriz Parejo-Carbonell
- Unidad de Epilepsia, Hospital Clínico San Carlos, Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain
| | | | - Daniela Di Capua
- Unidad de Epilepsia, Hospital Clínico San Carlos, Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain
| | - Irene García-Morales
- Unidad de Epilepsia, Hospital Clínico San Carlos, Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain
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Kim M, Kim YS, Kim DH, Yang TW, Kwon OY. Major depressive disorder in epilepsy clinics: A meta-analysis. Epilepsy Behav 2018; 84:56-69. [PMID: 29753295 DOI: 10.1016/j.yebeh.2018.04.015] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 04/20/2018] [Accepted: 04/20/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND PURPOSE Although depression is a frequent psychiatric comorbidity in people with epilepsy (PWE), its prevalence has been underestimated. Comorbid depression has negative impacts on treatment outcomes and quality of life (QOL). It also causes various problems in PWE, such as fatigue, irritability, and suicidality. This meta-analysis was performed to estimate the frequency of major depression disorder (MDD) in clinics managing PWE. METHODS We searched MEDLINE, EMBASE, Cochrane Library, Web of Science, and SCOPUS to identify studies. Hospital-based studies and original research presenting information regarding prevalence of MDD, determined using a gold standard diagnostic tool in adult PWE, were considered for inclusion. The prevalence of depression was examined by meta-analysis. In addition, subgroup analysis was performed based on the continent where the selected studies were conducted, the strictness of selection criteria, and gender. Strict selection criteria were defined as any mention of the use of exclusion criteria. RESULTS A total of 6607 studies were identified by searching the five databases outlined above. After screening and rescreening, 35 studies were included in the meta-analysis. The total number of PWE was 5434. In the test for heterogeneity of the studies, I2 was 68.014, and the Cochran Q value was 106.296 (p < 0.01). As a pooled estimate, the point prevalence of MDD in PWE was 21.9% with a 95% confidence interval (CI) of 20.8-23.0 in a fixed effects model. In subgroup analyses, continent partly explained the heterogeneity among the selected studies, but the strictness of selection criteria did not. The prevalence of MDD was higher in females than in males (26.4% vs. 16.7%, respectively) with an odds ratio (OR) of 1.805 (95% CI: 1.443-2.258; p < 0.01). CONCLUSIONS The point prevalence of MDD is estimated at 21.9% among PWE in epilepsy clinics and is higher in females than in males. Based on this relatively high prevalence in PWE, measures are required to identify and resolve MDD. In addition, the female predominance of MDD among PWE indicates a need to pay greater attention to females. Such efforts may reduce the impact of depression in PWE and improve their QOL.
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Affiliation(s)
- Minjung Kim
- Department of Neurology and Institute of Health Science, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Young-Soo Kim
- Department of Neurology and Institute of Health Science, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Do-Hyung Kim
- Department of Neurology and Institute of Health Science, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Tae-Won Yang
- Department of Neurology and Institute of Health Science, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Oh-Young Kwon
- Department of Neurology and Institute of Health Science, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea.
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Vallée C, Biraben A, Nica A, Loiseau M. [Epidemiology and associated factors with depression among people suffering from epilepsy: A transversal French study in a tertiary center]. Encephale 2018. [PMID: 29525447 DOI: 10.1016/j.encep.2017.12.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVES The occurrence of depression in people with epilepsy is almost twice as common as in the general population. Furthermore, depression is the first cause of lower quality of life among those patients. Which is why the main goal of this study was to assess the epidemiology of depression and its associated factors among the patients from the tertiary department of epileptology in Rennes. METHODS/RESULTS The subjects were included prospectively and consecutively at the moment of their consultation or hospitalisation in the department. Personal data about the socio-economic status and the type of epilepsy was collected. The subjects filled validated self-assessment of depression (NDDIE), anxiety (GAD-7) and quality of life (QOLIE-10). Thanks to the NDDIE, the patients were divided into: "depressed" and "not depressed"; and the two groups were compared with univariate and multivariate models. Of the 322 patients followed-up in the department between the 17th of June and the 9th of September 2016 223 of them were included in the study. According to the NDDIE, 22.6% suffered from depression; according to the GAD-7, 46.4% suffered from anxiety. In the "depressed" group, 82% were not under anti-depressant medication. In the univariate model, depression was associated with: anxiety, suicidal ideations, lower quality of life, vague nervus stimulation treatment, anticonvulsant benzodiazepine medication or psychiatric medication, and last of all bitherapy or polytherapy antiepileptic medication compared to monotherapy. In the multivariate model, depression was significantly related to anxiety (OR: 8.86 [3.00; 26.19] p=0.0001), suicidal ideas (OR: 7.43 [2.93; 18.81] p<0.0001), anticonvulsant benzodiazepine medication (OR: 3.31 [1.16; 9.49] p=0.0255), and lower quality of life (OR: 1.09 [1.02; 1.17] p=0.0087). Generalised epilepsy was a protective factor with uni and multivariate models (OR: 0.34 [0.11; 1.00] p=0.0492). CONCLUSIONS In the tertiary epileptic department of Rennes, more than 20% of patients with epilepsy suffered from depression during the inclusion period according to the NDDIE. Among those "depressed" subjects, fewer than one out of five seemed to receive proper psychiatric care. Which is why this study highlights the importance of interdisciplinary cooperation between neurologists and psychiatrists in order to aim at better management of epileptic patients as a whole.
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Affiliation(s)
- C Vallée
- DES de neurologie, CHU de Rennes, 35000 Rennes, France.
| | - A Biraben
- Département d'épileptologie, CHU de Rennes, 35000 Rennes, France.
| | - A Nica
- Département d'épileptologie, CHU de Rennes, 35000 Rennes, France
| | - M Loiseau
- DES de psychiatrie, CHU de Dijon, 21000 Dijon, France.
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Gmaj B, Majkowski J, Szczypiński J, Jędrzejczak J, Majkowska-Zwolińska B, Wojnar M, Gawłowicz J, Januszko P, Park SP, Nagańska E, Ziemka S, Wołyńczyk-Gmaj D. Validation of the Polish version of the Neurological Disorders Depression Inventory for Epilepsy (P-NDDI-E). JOURNAL OF EPILEPTOLOGY 2018. [DOI: 10.21307/jepil-2018-007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Wiglusz MS, Landowski J, Michalak L, Cubała WJ. Validation of the Polish version of the Beck Depression Inventory in patients with epilepsy. Epilepsy Behav 2017; 77:58-61. [PMID: 29111504 DOI: 10.1016/j.yebeh.2017.09.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 09/19/2017] [Accepted: 09/22/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND Despite the fact that depressive disorders are the most common comorbidities among patients with epilepsy (PWE), such disorders often go unrecognized and untreated. In addition, the availability of validated screening instruments to detect depression in PWE is limited. The aim of the present study was thus to validate the Polish version of the Beck Depression Inventory (BDI) in adult PWE. METHODS A group of 118 outpatient PWE were invited to participate in the study. Ninety-six patients meeting the inclusion criteria completed the Polish Version of Beck Depression Inventory-I (BDI-I) and were examined by a trained psychiatrist using the Structured Clinical Interview (SICD-I) for Diagnostic and statistical manual of mental disorders - fourth edition (Text revision) (DSM-IV-TR). Receiver operating characteristic (ROC) curves were used to determine the optimal threshold scores for BDI. RESULTS Receiver operating characteristic analysis showed the area under the curve to be approximately 84%. For major depressive disorder (MDD) diagnosis, the BDI demonstrated the best psychometric properties for a cut-off score to be 18, with a sensitivity of 90.5%, specificity of 70.7%, positive predictive value (PPV) of 46.3%, and negative predictive value (NPV) of 96.4%. For the 'any depressive disorder' group, the BDI optimum cut-off score was 11, with a sensitivity of 82.5%, specificity of 73.2%, PPV of 68.8%, and NPV of 85.4%. CONCLUSIONS The BDI score is a valid psychometric indicator for depressive disorders in PWE maintaining adequate sensitivity and specificity, high NPV, and acceptable PPV with an optimum cut-off score of 18 for MDD diagnosis.
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Affiliation(s)
| | - Jerzy Landowski
- Department of Psychiatry, Medical University of Gdańsk, Poland
| | - Lidia Michalak
- Regional Epilepsy Outpatient Unit, Copernicus Hospital, Gdańsk, Poland
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Gill SJ, Lukmanji S, Fiest KM, Patten SB, Wiebe S, Jetté N. Depression screening tools in persons with epilepsy: A systematic review of validated tools. Epilepsia 2017; 58:695-705. [DOI: 10.1111/epi.13651] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Stephanie J. Gill
- Department of Clinical Neurosciences; University of Calgary; Calgary Alberta Canada
- Hotchkiss Brain Institute; University of Calgary; Calgary Alberta Canada
| | - Sara Lukmanji
- Department of Clinical Neurosciences; University of Calgary; Calgary Alberta Canada
- Hotchkiss Brain Institute; University of Calgary; Calgary Alberta Canada
| | - Kirsten M. Fiest
- Hotchkiss Brain Institute; University of Calgary; Calgary Alberta Canada
- Department of Community Health Sciences and O'Brien Institute for Public Health; University of Calgary; Calgary Alberta Canada
- Department of Critical Care Medicine; University of Calgary; Calgary Alberta Canada
| | - Scott B. Patten
- Hotchkiss Brain Institute; University of Calgary; Calgary Alberta Canada
- Department of Community Health Sciences and O'Brien Institute for Public Health; University of Calgary; Calgary Alberta Canada
- Mathison Centre for Mental Health Research & Education; University of Calgary; Calgary Alberta Canada
- Department of Psychiatry; University of Calgary; Calgary Alberta Canada
| | - Samuel Wiebe
- Department of Clinical Neurosciences; University of Calgary; Calgary Alberta Canada
- Hotchkiss Brain Institute; University of Calgary; Calgary Alberta Canada
- Department of Community Health Sciences and O'Brien Institute for Public Health; University of Calgary; Calgary Alberta Canada
| | - Nathalie Jetté
- Department of Clinical Neurosciences; University of Calgary; Calgary Alberta Canada
- Hotchkiss Brain Institute; University of Calgary; Calgary Alberta Canada
- Department of Community Health Sciences and O'Brien Institute for Public Health; University of Calgary; Calgary Alberta Canada
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Major depressive episode, cognition, and epilepsy. Epilepsy Behav 2016; 64:219-223. [PMID: 27764732 DOI: 10.1016/j.yebeh.2016.09.035] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Revised: 08/21/2016] [Accepted: 09/16/2016] [Indexed: 12/28/2022]
Abstract
PURPOSE In patients with epilepsy (PWE), relationships between depression, epilepsy characteristics, and cognitive aspects are complex. This study aimed to assess the occurrence of possible major depressive episode in PWE and to verify whether it is associated with the clinical aspects of the disease and cognition. METHODS Two hundred consecutive PWE with a mean age and standard deviation of 47.6 (±15.1) years were included in the study. We determined whether their Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) scores were associated with their clinical, cognitive, and QOLIE-31 aspects using a significance level of 5% (p<0.05). RESULTS Twenty-six patients (13%) had an NDDI-E score >15, suggestive of major depressive episode. Logistic regression showed that NDDI-E >15 was associated with seizure frequency (p=0.022) and worse performance in the category fluency test (p=0.003). An NDDI-E >15 was also correlated with lower quality of life (p<0.001). CONCLUSION The present findings suggest that possible major depressive episode is associated not only with epilepsy characteristics but also with cognitive aspects, such as category fluency, and quality of life.
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Espinosa Jovel CA, Ramírez Salazar S, Rincón Rodríguez C, Sobrino Mejía FE. Factors associated with quality of life in a low-income population with epilepsy. Epilepsy Res 2016; 127:168-174. [DOI: 10.1016/j.eplepsyres.2016.08.031] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 08/17/2016] [Accepted: 08/31/2016] [Indexed: 10/21/2022]
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Wiglusz MS, Landowski J, Michalak L, Cubała WJ. Validation of the Polish Version of the Hamilton Rating Scale for Depression in patients with epilepsy. Epilepsy Behav 2016; 62:81-4. [PMID: 27450310 DOI: 10.1016/j.yebeh.2016.06.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 06/19/2016] [Accepted: 06/23/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Depressive disorders are the most common comorbidities among patients with epilepsy (PWE). The availability of standardized clinical instruments for PWE is limited with scarce validation studies available so far. The aim of the study was to validate the Polish Version of the Hamilton Rating Scale for Depression (HRSD) in adult PWE. METHODS A group of 96 outpatient PWE were examined by a trained psychiatrist using the Structured Clinical Interview (SCID-I) for DSM-IV-TR and the 17-item Polish Version of HRSD (HRSD-17). Receiver operating characteristic (ROC) curves were used to determine the optimal threshold scores. RESULTS The ROC analyses showed areas under the curve approximately 0.9. For diagnoses of MDD, HRSD-17 demonstrated the best psychometric properties for a cutoff score of 11 with sensitivity of 100%, specificity of 89.3%, positive predictive value of 72.4%, and negative predictive value of 100%. CONCLUSIONS The 17-item Polish Version of HRSD proved to be reliable and valid in the epilepsy setting with a cutoff score of 11 points.
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Affiliation(s)
| | - Jerzy Landowski
- Department of Psychiatry, Medical University of Gdańsk, Poland
| | - Lidia Michalak
- Regional Epilepsy Outpatient Unit, Copernicus Hospital, Gdańsk, Poland
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Micoulaud-Franchi JA, Lagarde S, Barkate G, Dufournet B, Besancon C, Trébuchon-Da Fonseca A, Gavaret M, Bartolomei F, Bonini F, McGonigal A. Rapid detection of generalized anxiety disorder and major depression in epilepsy: Validation of the GAD-7 as a complementary tool to the NDDI-E in a French sample. Epilepsy Behav 2016; 57:211-216. [PMID: 26994447 DOI: 10.1016/j.yebeh.2016.02.015] [Citation(s) in RCA: 128] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 02/09/2016] [Accepted: 02/10/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Generalized anxiety disorder (GAD) in people with epilepsy (PWE) is underdiagnosed and undertreated. The GAD-7 is a screening questionnaire to detect GAD. However, the usefulness of the GAD-7 as a screening tool in PWE remains to be validated. Thus, we aimed to: (1) validate the GAD-7 in French PWE and (2) assess its complementarity with regard to the previously validated screening tool for depression, the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E). METHODS This study was performed under the auspices of the ILAE Commission on Neuropsychiatry. People with epilepsy >18 years of age were recruited from the specialist epilepsy unit in Marseille, France. The Mini-International Neuropsychiatric Interview (MINI) was performed as gold standard, and the Penn State Worry Questionnaire (PSWQ) and the NDDI-E were performed for external validity. Data were compared between PWE with/without GAD using Chi(2) test and Student's t-test. Internal structural validity, external validity, and receiver operator characteristics were analyzed. A principal component factor analysis with Varimax rotation was performed on the 13 items of the GAD-7 (7 items) plus the NDDI-E (6 items). RESULTS Testing was performed on 145 PWE: mean age = 39.38 years old (SD=14.01, range: 18-75); 63.4% (92) women; 75.9% with focal epilepsy. Using the MINI, 49 (33.8%) patients had current GAD. Cronbach's alpha coefficient was 0.898, indicating satisfactory internal consistency. Correlation between GAD-7 and the PSQW scores was high (r (145)=.549, P<.0001), indicating good external validity. Factor analysis shows that the anxiety investigated with the GAD-7 and depression investigated with the NDDI-E reflect distinct factors. Receiver operator characteristic analysis showed area under the curve of 0.899 (95% CI 0.838-0.943, P < 0.0001) indicating good capacity of the GAD-7 to detect GAD (defined by MINI). Cutoff for maximal sensitivity and specificity was 7. Mean GAD-7 score in PWE with GAD was 13.22 (SD = 3.99), and that without GAD was 5.17 (SD = 4.66). SIGNIFICANCE This study validates the French language version of the GAD-7 screening tool for generalized anxiety in PWE, with a cutoff score of 7/21 for GAD, and also confirms that the GAD-7 is a short and easily administered test. Factor analysis shows that the GAD-7 (screening for generalized anxiety disorder) and the NDDI-E (screening for major depression) provide complementary information. The routine use of both GAD-7 and NDDI-E should be considered in clinical evaluation of patients with epilepsy.
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Affiliation(s)
- Jean-Arthur Micoulaud-Franchi
- Services d'explorations fonctionnelles du système nerveux, Clinique du sommeil, CHU de Bordeaux, Place Amélie Raba-Leon, 33076 Bordeaux, France; USR CNRS 3413 SANPSY, CHU Pellegrin, Université de Bordeaux, France
| | - Stanislas Lagarde
- Service de Neurophysiologie Clinique, APHM, Hôpital de la Timone, 13005 Marseille, France
| | - Gérald Barkate
- Hôpital Henri Gastaut, Etablissement Hospitalier Spécialisé dans le traitement des Epilepsies, 300 Boulevard de Sainte-Marguerite, 13009 Marseille, France
| | - Boris Dufournet
- Service de Neurophysiologie Clinique, APHM, Hôpital de la Timone, 13005 Marseille, France
| | - Cyril Besancon
- Hôpital Henri Gastaut, Etablissement Hospitalier Spécialisé dans le traitement des Epilepsies, 300 Boulevard de Sainte-Marguerite, 13009 Marseille, France
| | - Agnès Trébuchon-Da Fonseca
- Service de Neurophysiologie Clinique, APHM, Hôpital de la Timone, 13005 Marseille, France; INSERM UMR 1106, INS, 27 Bd Jean Moulin, 13385 Marseille, France; Aix Marseille Université, Faculté de Médecine, Marseille, France
| | - Martine Gavaret
- Service de Neurophysiologie Clinique, APHM, Hôpital de la Timone, 13005 Marseille, France; INSERM UMR 1106, INS, 27 Bd Jean Moulin, 13385 Marseille, France; Aix Marseille Université, Faculté de Médecine, Marseille, France
| | - Fabrice Bartolomei
- Service de Neurophysiologie Clinique, APHM, Hôpital de la Timone, 13005 Marseille, France; INSERM UMR 1106, INS, 27 Bd Jean Moulin, 13385 Marseille, France; Aix Marseille Université, Faculté de Médecine, Marseille, France; Hôpital Henri Gastaut, Etablissement Hospitalier Spécialisé dans le traitement des Epilepsies, 300 Boulevard de Sainte-Marguerite, 13009 Marseille, France
| | - Francesca Bonini
- Service de Neurophysiologie Clinique, APHM, Hôpital de la Timone, 13005 Marseille, France; INSERM UMR 1106, INS, 27 Bd Jean Moulin, 13385 Marseille, France; Aix Marseille Université, Faculté de Médecine, Marseille, France
| | - Aileen McGonigal
- Service de Neurophysiologie Clinique, APHM, Hôpital de la Timone, 13005 Marseille, France; INSERM UMR 1106, INS, 27 Bd Jean Moulin, 13385 Marseille, France; Aix Marseille Université, Faculté de Médecine, Marseille, France.
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Validation of the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) Serbian version. Epilepsy Behav 2016; 57:1-4. [PMID: 26900772 DOI: 10.1016/j.yebeh.2016.01.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2015] [Revised: 01/10/2016] [Accepted: 01/14/2016] [Indexed: 11/23/2022]
Abstract
The Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) was developed and proven efficient for the rapid detection of a major depressive episode in people with epilepsy. This study describes the development, validation, and psychometric properties of the NDDI-E Serbian version. A consecutive sample of 103 patients with epilepsy was assessed using the Beck Depression Inventory (BDI) and the NDDI-E. All patients had no major difficulties in understanding or answering the questions of the Serbian version. Cronbach's alpha coefficient was 0.763. Receiver operating characteristic analysis showed an area under the curve of 0.943 (95% CI; 0.826 to 0.951), a cutoff score of ≥14, a sensitivity of 72.2%, a specificity of 95.2%, a positive predictive value of 81.3%, and a negative predictive value of 94.3%. The NDDI-E Serbian version scores were significantly and positively correlated with those of the BDI (p<0.001). The NDDI-E Serbian version constitutes a concise and consistent depression screening instrument for patients with epilepsy.
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Hansen CP, Amiri M. Combined detection of depression and anxiety in epilepsy patients using the Neurological Disorders Depression Inventory for Epilepsy and the World Health Organization well-being index. Seizure 2015; 33:41-5. [DOI: 10.1016/j.seizure.2015.10.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Revised: 09/15/2015] [Accepted: 10/17/2015] [Indexed: 10/22/2022] Open
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Wiglusz MS, Landowski J, Michalak L, Cubała WJ. Reevaluating the prevalence and diagnostic subtypes of depressive disorders in epilepsy. Epilepsy Behav 2015; 53:15-9. [PMID: 26515153 DOI: 10.1016/j.yebeh.2015.09.029] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 09/20/2015] [Accepted: 09/21/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Depressive disorders are common among patients with epilepsy (PWE). The aim of this study was to estimate the prevalence of different forms of depressive disorders among PWE treated in the outpatient setting. METHODS A group of consecutive PWE that visited the epilepsy outpatient clinic was invited to participate in the study. Ninety-six patients met inclusion criteria and were examined by a trained psychiatrist using standardized measures. RESULTS A diagnosis of a current major depression was established in 21 (22.3%) out of 96 participants. Furthermore, almost 20% of the study group fulfilled criteria for mood disorder categories other than MDD, adding up to over 40% of PWE suffering from any mood disorder category. Older age and later age at seizure onset, as well as unemployment, were associated with an increase in the odds of MDD diagnosis. STUDY LIMITATIONS A number of limitations are to be considered: the sample size is relatively small, and the findings may not be representative of PWE in general because our population represents a sample coming from a single outpatient clinic with a higher ratio of drug-resistant epilepsy. CONCLUSIONS Major depression as well as other forms of depressive disorders are common among PWE. Unemployment, age, and age at seizure onset are important factors associated with major depression among PWE.
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Affiliation(s)
| | - Jerzy Landowski
- Department of Psychiatry, Medical University of Gdańsk, Poland
| | - Lidia Michalak
- Regional Epilepsy Outpatient Unit, Copernicus Hospital, Gdańsk, Poland
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Myers L, Lancman M, Vazquez-Casals G, Bonafina M, Perrine K, Sabri J. Depression and quality of life in Spanish-speaking immigrant persons with epilepsy compared with those in English-speaking US-born persons with epilepsy. Epilepsy Behav 2015; 51:146-51. [PMID: 26277451 DOI: 10.1016/j.yebeh.2015.07.024] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 07/17/2015] [Accepted: 07/18/2015] [Indexed: 12/27/2022]
Abstract
OBJECTIVE This study aimed to examine levels of depression and quality of life in Spanish-speaking (less acculturated) immigrants with epilepsy compared with those in English-speaking US-born persons with epilepsy (PWEs). METHODS The study included 85 PWEs - 38 Spanish-speaking immigrants with epilepsy and 47 US-born PWEs. All patients underwent video-EEG monitoring and completed depression and quality-of-life inventories in their dominant language (Spanish/English). Chart review of clinical epilepsy variables was conducted by an epileptologist. RESULTS Our study revealed that depression scores were significantly higher in Hispanic PWEs (21.65±14.6) than in US-born PWEs (14.50±10.2) (t (64.02)=-2.3, two-sided p=.025). Marital status, medical insurance, antidepressant use, seizure frequency, and number of antiepileptic drugs (AEDs) were tested as covariates in the ANCOVA framework and were not statistically significant at the 0.05 significance level. Fewer Hispanics were prescribed antidepressant medications (13.15% for Hispanics and 40.42% for US-born, χ(2) (1,85) 7.71, p=.005) and had access to comprehensive health insurance coverage (χ(2) (1,85)=13.70, p=0.000). Hispanic patients were also found to be receiving significantly less AEDs compared with their US-born peers (t (83, 85)=2.33, p=.02). Although quality of life was diminished in both groups, Seizure Worry was worse for Hispanics after accounting for potential effects of marital status, medical insurance, use of antidepressants, seizure frequency, and number of antiepileptic drugs (AEDs) ((1, 83), F=7.607, p=0.007). SIGNIFICANCE The present study is the first of its kind to examine depression and quality of life in Spanish-speaking US immigrants with epilepsy. Spanish-speaking immigrants with epilepsy have been identified as a group at risk. They demonstrated higher depression scores and more Seizure Worry independent of epilepsy and demographic characteristics compared with their US-born peers. The Hispanic group was receiving less treatment for depression, was taking less AEDs, and had less access to comprehensive health coverage compared with non-Hispanics.
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Affiliation(s)
- Lorna Myers
- Northeast Regional Epilepsy Group, 820 Second Avenue, Suite 6C, New York, NY 10017, USA.
| | - Marcelo Lancman
- Northeast Regional Epilepsy Group, 820 Second Avenue, Suite 6C, New York, NY 10017, USA
| | - Gonzalo Vazquez-Casals
- North Shore/Long Island Jewish, Brain Injury Unit, 101 St. Andrews Lane, Glen Cove, NY 11542, USA
| | - Marcela Bonafina
- Northeast Regional Epilepsy Group, 820 Second Avenue, Suite 6C, New York, NY 10017, USA
| | - Kenneth Perrine
- Northeast Regional Epilepsy Group, 820 Second Avenue, Suite 6C, New York, NY 10017, USA; Department of Neurological Surgery, Weill Cornell Medical College, 520 E. 70th St., Starr 651, New York, NY 10065, USA
| | - Jomard Sabri
- Northeast Regional Epilepsy Group, 820 Second Avenue, Suite 6C, New York, NY 10017, USA
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Tong X, An D, Lan L, Zhou X, Zhang Q, Xiao F, Park SP, Kanemoto K, Kanner AM, Zhou D. Validation of the Chinese version of the Neurological Disorders Depression Inventory for Epilepsy (C-NDDI-E) in West China. Epilepsy Behav 2015; 47:6-10. [PMID: 26004785 DOI: 10.1016/j.yebeh.2015.03.012] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 03/09/2015] [Accepted: 03/10/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE We aimed to validate the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) for Chinese people with epilepsy (PWE). METHODS The NDDI-E was translated into a Chinese version. A consecutive cohort of PWE from West China Hospital was recruited to test the reliability and validity of the Chinese version of the NDDI-E (C-NDDI-E). Each patient underwent the Mini International Neuropsychiatric Interview (MINI) and C-NDDI-E. RESULTS A total of 202 PWE completed the psychiatric evaluation. The C-NDDI-E was easily comprehended and quickly completed by all participants. Fifty-four patients (26.7%) had current major depressive disorder (MDD) according to the MINI criteria. The Cronbach's α coefficient for the C-NDDI-E was 0.825. Receiver operating characteristic analyses showed an area under the curve of 0.936 (95% CI=0.904-0.968). At a cutoff score of >12, the C-NDDI-E had a sensitivity of 0.926, a specificity of 0.804, a positive predictive value of 0.633, and a negative predictive value of 0.967. CONCLUSION The C-NDDI-E is a valuable instrument for screening MDD in Chinese PWE.
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Affiliation(s)
- Xin Tong
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China.
| | - Dongmei An
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China.
| | - Lili Lan
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China.
| | - Xiaobo Zhou
- Department of Psychiatry, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China.
| | - Qin Zhang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China.
| | - Fenglai Xiao
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China.
| | - Sung-Pa Park
- Department of Neurology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
| | - Kousuke Kanemoto
- Department of Neuropsychiatry, School of Medicine, Aichi Medical University, Nagakute, Japan.
| | - Andres M Kanner
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA.
| | - Dong Zhou
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China.
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Guo Y, Chen ZM, Zhang YX, Ge YB, Shen CH, Ding Y, Wang S, Tang YL, Ding MP. Reliability and validity of the Chinese version of the Neurological Disorders Depression Inventory for Epilepsy (C-NDDI-E). Epilepsy Behav 2015; 45:225-8. [PMID: 25825367 DOI: 10.1016/j.yebeh.2015.01.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 01/14/2015] [Accepted: 01/16/2015] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the clinical reliability and validity of the Chinese version of the Neurological Disorders Depression Inventory for Epilepsy (C-NDDI-E). METHODS A total of 248 Chinese patients with epilepsy underwent psychometric tests, including the Chinese version of the Mini International Neuropsychiatric Interview (C-MINI), the Chinese version of the Beck Depression Inventory - II (C-BDI-II), and the C-NDDI-E. RESULTS None of the patients had difficulties understanding or completing the C-NDDI-E. Cronbach's α coefficient was 0.824. At a cutoff score of ≥14, the C-NDDI-E had a sensitivity of 0.854, a specificity of 0.899, a positive predictive value of 0.625, and a negative predictive value of 0.969. The scores for the C-NDDI-E were positively correlated with those for the C-BDI-II (P<0.001). CONCLUSION The C-NDDI-E is a reliable and valid screening tool for the detection of major depression in Chinese patients with epilepsy.
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Affiliation(s)
- Yi Guo
- Department of Neurology, Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Zhe-Meng Chen
- Department of Neurology, Jiaxing First Hospital, Jiaxing, China
| | - Yin-Xi Zhang
- Department of Neurology, Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ye-Bo Ge
- Department of Neurology, Ningbo Yinxian Hospital, Ningbo, China
| | - Chun-Hong Shen
- Department of Neurology, Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yao Ding
- Department of Neurology, Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Shuang Wang
- Department of Neurology, Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ye-Lei Tang
- Department of Neurology, Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Mei-Ping Ding
- Department of Neurology, Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
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Micoulaud-Franchi JA, Barkate G, Trébuchon-Da Fonseca A, Vaugier L, Gavaret M, Bartolomei F, McGonigal A. One step closer to a global tool for rapid screening of major depression in epilepsy: validation of the French NDDI-E. Epilepsy Behav 2015; 44:11-6. [PMID: 25597527 DOI: 10.1016/j.yebeh.2014.12.011] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 12/06/2014] [Accepted: 12/09/2014] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Depression in people with epilepsy (PWE) is underdiagnosed and undertreated. The Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) is a screening questionnaire used for detecting major depressive episode (MDE) in PWE, and is already validated in 10 languages. However a version in French, one of the world's widely spoken languages, was, until now, lacking. We aimed to translate and validate the French NDDI-E. METHODS This study was performed under the auspices of the ILAE. People with epilepsy >18years of age were recruited from 2 specialist epilepsy units in Marseille, France. Two native French speakers and 2 native English speakers performed a forward-backward translation. The Mini International Neuropsychiatric Interview (MINI) was performed as the gold standard, and the Center for Epidemiological Studies Depression symptoms index (CES-D) was performed for external validity. Data were compared between PWE with MDE and PWE without MDE using the chi-square test and Student's t-test. Internal structural validity, external validity, and receiver operator characteristics were analyzed. RESULTS Testing was performed on 116 PWE: mean age=40.39years (SD=13.83, range: [18-81]years old); 58.6% (68) were women; 87.1% had focal epilepsy. Using the MINI, we found that 33 (28.4%) patients had current MDE and that 15 (12.9%) patients had dysthymia; also, we found that 37 (31.9%) patients presented suicidal ideation and/or behavior. Cronbach's alpha coefficient was 0.838, indicating satisfactory internal consistency. Correlation between the NDDI-E and the CES-D scores was high (r(116)=0.817, p<0.0001), indicating good external validity. Receiver operator characteristic analysis showed an area under the curve of 0.958 (95% CI=0.904-0.986), (p<0.0001), indicating good capacity of the NDDI-E to detect MDE (defined by MINI). The cutoff for maximal sensitivity and specificity was 15. The mean NDDI-E score in PWE with MDE was 18.27 (SD=2.28), and the mean NDDI-E score in PWE without MDE was 10.61 (SD=3.63). SIGNIFICANCE This study validated the French NDDI-E, with a cutoff score of 15/24 for MDE, similar to previous studies, and reinforces the NDDI-E as a global tool for detection of MDE.
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Affiliation(s)
- Jean-Arthur Micoulaud-Franchi
- Pôle de Psychiatrie "Solaris", Centre Hospitalier Universitaire de Sainte-Marguerite, 270 Bd de Sainte-Marguerite, 13009 Marseille, France; Laboratoire de Neurosciences Cognitives, UMR CNRS 7291, 31 Aix-Marseille Université, 13331 Marseille, France
| | - Gérald Barkate
- Hôpital Henri Gastaut, Etablissement Hospitalier Spécialisé dans le traitement des Epilepsies, 300 Boulevard de Sainte-Marguerite, 13009 Marseille, France
| | - Agnès Trébuchon-Da Fonseca
- Service de Neurophysiologie Clinique, APHM, Hôpital de la Timone, 13005 Marseille, France; INSERM UMR 1106, INS, 27 Bd Jean Moulin, 13385 Marseille, France; Aix Marseille Université, Faculté de Médecine, Marseille, France
| | - Lisa Vaugier
- Service de Neurophysiologie Clinique, APHM, Hôpital de la Timone, 13005 Marseille, France; Service de Neurophysiologie Clinique, APHM, Hôpital Nord, 13015 Marseille, France
| | - Martine Gavaret
- Service de Neurophysiologie Clinique, APHM, Hôpital de la Timone, 13005 Marseille, France; INSERM UMR 1106, INS, 27 Bd Jean Moulin, 13385 Marseille, France; Aix Marseille Université, Faculté de Médecine, Marseille, France
| | - Fabrice Bartolomei
- Service de Neurophysiologie Clinique, APHM, Hôpital de la Timone, 13005 Marseille, France; INSERM UMR 1106, INS, 27 Bd Jean Moulin, 13385 Marseille, France; Aix Marseille Université, Faculté de Médecine, Marseille, France; Hôpital Henri Gastaut, Etablissement Hospitalier Spécialisé dans le traitement des Epilepsies, 300 Boulevard de Sainte-Marguerite, 13009 Marseille, France
| | - Aileen McGonigal
- Service de Neurophysiologie Clinique, APHM, Hôpital de la Timone, 13005 Marseille, France; INSERM UMR 1106, INS, 27 Bd Jean Moulin, 13385 Marseille, France; Aix Marseille Université, Faculté de Médecine, Marseille, France.
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Zis P, Gatzonis S. Estimating the diagnostic value of the Neurological Disorders Depression Inventory for Epilepsy in different languages. Epilepsia 2014; 55:941. [PMID: 24924643 DOI: 10.1111/epi.12609] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Panagiotis Zis
- Department of Neurology, Evangelismos General Hospital, Athens, Greece.
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Kwon OY, Park SP. Depression and anxiety in people with epilepsy. J Clin Neurol 2014; 10:175-88. [PMID: 25045369 PMCID: PMC4101093 DOI: 10.3988/jcn.2014.10.3.175] [Citation(s) in RCA: 173] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 02/19/2014] [Accepted: 02/21/2014] [Indexed: 11/17/2022] Open
Abstract
Many recent epidemiological studies have found the prevalence of depression and anxiety to be higher in people with epilepsy (PWE) than in people without epilepsy. Furthermore, people with depression or anxiety have been more likely to suffer from epilepsy than those without depression or anxiety. Almost one-third of PWE suffer from depression and anxiety, which is similar to the prevalence of drug-refractory epilepsy. Various brain areas, including the frontal, temporal, and limbic regions, are associated with the biological pathogenesis of depression in PWE. It has been suggested that structural abnormalities, monoamine pathways, cerebral glucose metabolism, the hypothalamic-pituitary-adrenal axis, and interleukin-1b are associated with the pathogenesis of depression in PWE. The amygdala and the hippocampus are important anatomical structures related to anxiety, and γ-aminobutyric acid and serotonin are associated with its pathogenesis. Depression and anxiety may lead to suicidal ideation or attempts and feelings of stigmatization. These experiences are also likely to increase the adverse effects associated with antiepileptic drugs and have been related to poor responses to pharmacological and surgical treatments. Ultimately, the quality of life is likely to be worse in PWE with depression and anxiety than in PWE without these disorders, which makes the early detection and appropriate management of depression and anxiety in PWE indispensable. Simple screening instruments may be helpful for in this regard, particularly in busy epilepsy clinics. Although both medical and psychobehavioral therapies may ameliorate these conditions, randomized controlled trials are needed to confirm that.
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Affiliation(s)
- Oh-Young Kwon
- Department Neurology and Institute of Health Science, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Sung-Pa Park
- Department of Neurology, School of Medicine, Kyungpook National University, Daegu, Korea
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Seo JG, Cho YW, Lee SJ, Lee JJ, Kim JE, Moon HJ, Park SP. Validation of the generalized anxiety disorder-7 in people with epilepsy: a MEPSY study. Epilepsy Behav 2014; 35:59-63. [PMID: 24798411 DOI: 10.1016/j.yebeh.2014.04.005] [Citation(s) in RCA: 121] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 04/05/2014] [Accepted: 04/07/2014] [Indexed: 10/25/2022]
Abstract
The Generalized Anxiety Disorder-7 (GAD-7) is a valuable instrument to screen for anxiety in primary care patients. However, it has not been validated in people with epilepsy (PWE). Therefore, we validated the GAD-7 and examined its differential effect from adverse effects of antiepileptic drugs (AEDs) on the detection of anxiety in Korean PWE. Eligible patients who visited outpatient clinics in 4 tertiary care hospitals and 1 secondary care hospital underwent several instruments including the Mini International Neuropsychiatric Interview-Plus Version 5.0.0 (MINI-Plus 5.0.0), the Korean version of the Neurological Disorders Depression Inventory for Epilepsy (K-NDDI-E), the Korean version of the Liverpool Adverse Event Profile (K-LAEP), and the Quality of Life in Epilepsy-10 (QOLIE-10). Two hundred forty-three patients were enrolled in the study, and 51 (21.0%) patients had GAD by the MINI-Plus 5.0.0. Cronbach's α coefficient for the GAD-7 was 0.924. At a cutoff score of 6, the GAD-7 had a sensitivity of 92.2%, a specificity of 89.1%, a positive predictive value of 69.1%, and a negative predictive value of 97.7%. The GAD-7 score was well correlated with the K-NDDI-E score, the K-LAEP score, and the QOLIE-10 overall and subscale scores. The impact of adverse effects of AEDs on the GAD-7 was less than that on the K-NDDI-E. In conclusion, the GAD-7 is a reliable and valid screening tool for detecting GAD in PWE.
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Affiliation(s)
- Jong-Geun Seo
- Department of Neurology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Yong Won Cho
- Department of Neurology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Se-Jin Lee
- Department of Neurology, Yeungnam University College of Medicine, Daegu, Republic of Korea
| | - Jang-Joon Lee
- Department of Neurology, Daegu Fatima Hospital, Republic of Korea
| | - Ji-Eun Kim
- Department of Neurology, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea
| | - Hye-Jin Moon
- Department of Neurology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Sung-Pa Park
- Department of Neurology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
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Alkhamees HA, Selai CE, Shorvon SD, Kanner AM. The use of the NDDI-E in Arabic to identify symptoms of depression of moderate or greater severity in people with epilepsy. Epilepsy Behav 2014; 32:55-8. [PMID: 24486924 DOI: 10.1016/j.yebeh.2014.01.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 01/05/2014] [Indexed: 10/25/2022]
Abstract
AIM The aims of the current study were to translate and to validate the NDDI-E to the Arabic language to be used as a screening instrument to identify moderately severe symptoms of depression in people with epilepsy. METHODS The English version of the NDDI-E was translated to Arabic and back translated to English by two independent translators. A total of 51 patients, aged 18-56years old, with a diagnosis of epilepsy, completed the Arabic versions of the Beck Depression Inventory (BDI-II) and the NDDI-E. Patients with BDI scores >20 were considered to be suffering from moderately severe depressive symptoms. Cutoff scores, sensitivity, specificity, and positive and negative predictive values of the NDDI-E to identify symptomatic patients on the BDI were calculated. RESULTS A sensitivity of 93.33% and a specificity of 94.44% were found with NDDI-E total scores >15. The positive predictive value was 87.5%, and the negative predictive value was 97.14%. Spearman's rank correlation between the BDI and the NDDI-E was high (r=.78, p=0.000, N=51). Internal consistency was at 0.926 (Cronbach's alpha). CONCLUSION The Arabic version of the NDDI-E appears to be a reliable and sensitive instrument in the identification of moderately severe or severe depressive symptoms in people with epilepsy, and it can be used with all Arabic-speaking patients.
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Affiliation(s)
- Hadeel A Alkhamees
- Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, London, UK.
| | - Caroline E Selai
- Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, London, UK
| | - Simon D Shorvon
- Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, London, UK
| | - Andres M Kanner
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA
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Thomson AE, Calle A, Fontela ME, Yepez L, Muñoz Giacomelli F, Jáuregui A, Racosta JM, Kanner AM. Screening of major depression in epilepsy: The Neurologic Depression Disorders Inventory in Epilepsy-Spanish version (Argentina). Epilepsia 2014; 55:331-4. [DOI: 10.1111/epi.12503] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Alfredo E. Thomson
- Department of Neurology; Institute of Neurosciences at Favaloro University; Buenos Aires Argentina
- Institute of Cognitive Neurology (INECO); Buenos Aires Argentina
- Department of Neurology; British Hospital; Buenos Aires Argentina
| | - Analía Calle
- Department of Neurology; Institute of Neurosciences at Favaloro University; Buenos Aires Argentina
| | - María E. Fontela
- Department of Neurology; Institute of Neurosciences at Favaloro University; Buenos Aires Argentina
- Institute of Cognitive Neurology (INECO); Buenos Aires Argentina
| | - Luis Yepez
- Center of Cerebral Investigations; Institute of Neurosciences; Junta de Beneficencia; Guayaquil Ecuador
| | | | - Agustín Jáuregui
- Department of Neurology; Institute of Neurosciences at Favaloro University; Buenos Aires Argentina
| | - Juan M. Racosta
- Department of Neurology; Institute of Neurosciences at Favaloro University; Buenos Aires Argentina
| | - Andrés M. Kanner
- Department of Neurology; Miller School of Medicine; University of Miami; Miami Florida U.S.A
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Schnelle Erkennung einer depressiven Störung bei Menschen mit Epilepsie. DER NERVENARZT 2014; 85:1151-5. [DOI: 10.1007/s00115-013-3982-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Zis P, Yfanti P, Siatouni A, Tavernarakis A, Gatzonis S. Validation of the Greek version of the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E). Epilepsy Behav 2013; 29:513-5. [PMID: 24100250 DOI: 10.1016/j.yebeh.2013.09.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Revised: 09/04/2013] [Accepted: 09/06/2013] [Indexed: 12/01/2022]
Abstract
The Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) was developed as a screening tool for symptoms of major depressive episodes in people with epilepsy. Our study describes the development, validation, and psychometric properties of the Greek version of the NDDI-E. A consecutive sample of 101 patients with epilepsy, eligible to participate in the study, has been assessed using the Mini International Neuropsychiatric Interview version 5.0.0 and the NDDI-E. All patients had no major difficulties in understanding or answering the questions of the Greek version. Cronbach's alpha coefficient was 0.74. Receiver operating characteristic analysis showed an area under the curve of 91% (95% CI=83%-99%; SE: 0.040, p<0.001). At a cutoff score of greater than 15, the NDDI-E showed a sensitivity of 91%, a specificity of 81%, and a negative predictive value of 97%.
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Affiliation(s)
- Panagiotis Zis
- Department of Neurology, Evangelismos Hospital, Athens, Greece.
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Metternich B, Wagner K, Buschmann F, Anger R, Schulze-Bonhage A. Validation of a German version of the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E). Epilepsy Behav 2012; 25:485-8. [PMID: 23153711 DOI: 10.1016/j.yebeh.2012.10.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Revised: 09/16/2012] [Accepted: 10/11/2012] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Goal of the present study was the validation of a German version of the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E). METHODS 197 adult epilepsy patients completed the NDDI-E (185 completed both the NDDI-E and BDI). 95 patients received psychiatric consults. RESULTS 33 patients received a diagnosis of major depression according to ICD-10 criteria. Internal consistency of the NDDI-E was .83. Receiver operating characteristics (ROC) showed an area under the curve of 0.92. Applying a cutoff score of ≥14 resulted in both sensitivity and specificity of 0.85. In the subsample with psychiatric consult, at the same optimal cutoff, sensitivity was 0.92, and specificity was 0.86. Further analyses showed a high concurrent validity with the BDI. DISCUSSION The German version of the NDDI-E constitutes a brief and reliable depression screening instrument for epilepsy patients.
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Reliability and validity of the Korean version of the Neurological Disorders Depression Inventory for Epilepsy (K-NDDI-E). Epilepsy Behav 2012; 25:539-42. [PMID: 23153718 DOI: 10.1016/j.yebeh.2012.09.010] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Revised: 09/10/2012] [Accepted: 09/10/2012] [Indexed: 11/20/2022]
Abstract
The Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) was developed as a screening instrument for rapid detection of major depression in people with epilepsy (PWE). We evaluated the reliability and validity of the Korean version of the NDDI-E (K-NDDI-E) in Korean PWE. This study applied to 121 outpatients who underwent psychometric tests including the Mini International Neuropsychiatric Interview-Plus Version 5.0.0, Beck Depression Inventory-II (BDI-II), and K-NDDI-E. The K-NDDI-E was easily comprehended and quickly completed by the patients. Cronbach's α coefficient was 0.898. At a cut off score of 11, the K-NDDI-E had a sensitivity of 84.6%, a specificity of 85.3%, a positive predictive value of 61.1%, and a negative predictive value of 95.3%. The scores of the K-NDDI-E had a positive correlation with those of the BDI-II (p<0.001). In conclusion, the K-NDDI-E is a reliable and valid screening tool to detect major depression in Korean PWE.
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Metternich B, Wagner K, Buschmann F, Anger R, Schulze-Bonhage A. Depressionsscreening bei Epilepsiepatienten. ZEITSCHRIFT FUR EPILEPTOLOGIE 2012. [DOI: 10.1007/s10309-012-0269-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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