Citation

Gandy M, Sharpe L, Nicholson Perry K, Miller L, Thayer Z, Boserio J, Mohamed A. Neurology 2012; 79(4): 371-375.

Affiliation

From the School of Psychology (M.G., L.S.), University of Sydney, Sydney; Centre for Health Research/School of Psychology (K.N.P.), University of Western Sydney, Sydney; Institute of Clinical Neurosciences (L.M., Z.T., J.B., A.M.), The Royal Prince Alfred Hospital, Sydney; and Medical School (L.M., A.M.), University of Sydney, Sydney, Australia.

Copyright

(Copyright © 2012, Lippincott Williams and Wilkins)

DOI

10.1212/WNL.0b013e318260cbfc

PMID

22786594

Abstract

OBJECTIVES:The aim of this study was to compare the efficacy of the Neurological Depressive Disorders Inventory for Epilepsy (NDDI-E) and the depression component of the Hospital Anxiety Depression Scale (HADS-D) for identifying depression and suicide risk in adults with epilepsy. METHODS:A total of 147 (87 female [59%]) outpatients attending a tertiary epilepsy center in Sydney Australia completed the NDDI-E and HADS-D. They then completed the depression and suicide sections of the Mini International Neuropsychiatric Inventory (MINI) with a clinician blind to symptom measure scores. Receiver operator characteristic analysis was performed for the clinical cutoff scores for depression on the NDDI-E ≥15 and HADS-D ≥8 to identify MINI-determined depression and suicidality. RESULTS:The NDDI-E indicated strong sensitivity (84%) and acceptable specificity (78%), whereas the HADS-D had poor sensitivity (42%) but good specificity (97%) for identifying depression. For identifying suicide risk, the NDDI-E indicated strong sensitivity (81%) and reasonable specificity (66%), whereas the HADS-D had poor sensitivity (43%) but acceptable specificity (90%). Area under the curve comparisons for these measures were not significant. CONCLUSION:In clinical practice, it is essential that screening measures have the highest possible sensitivity values to limit the chances of false-negative results. In accordance with these guidelines, the NDDI-E was a superior screening measure compared with the HADS-D. Our results demonstrate the efficacy of the NDDI-E for identifying both major and minor depression and serious suicide risk. The poor sensitivity of the HADS-D suggests that it should not be used as a screen for depression or suicidality in adults with epilepsy.

Language: en