Journal
NEUROLOGY
Volume 79, Issue 4, Pages 371-375Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1212/WNL.0b013e318260cbfc
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Funding
- National Health Research Council of Australia
- Molly McDonnell Foundation of the Epilepsy Society of Australia
- National Health and Medical Research Council
- University of Western Sydney
- Spinal Cord Injury Network
- ARC Centre of Excellence
- Royal Prince Alfred Hospital
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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. Neurology (R) 2012;79:371-375
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