Screening of Mood Disorders Using Self-Reports In Patients with Epilepsy: Sensitivity and Specificity
Banta, Albert Stephen, Jr.
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The prevalence of mood and anxiety disorders in outpatients with epilepsy seen at a tertiary care epilepsy center and the impact of these disorders on patient quality of life are not well defined. Also methods designed to assist physicians in the rapid diagnosis of these disorders, such as those used by Jones et al 2005a;b, need further assessment. Eligible outpatients (N = 88) with a diagnosis of epilepsy presenting at a tertiary care center were enrolled in the study during October 2006 to May 2007. After providing consent, patients had undergone the 16 item Quick Inventory of Depressive Symptomatology-Self Rating (QIDS-SR16), Beck Depression Inventory-II (BDI-II), Quality of Life Inventory in Epilepsy-31 (QOLE-31) and the Mood Disorders Questionnaire (MDQ). Eligible patients were contacted within three days of initial screening via telephone and underwent the Mini International Neuropsychiatric Interview (MINI) and the 16 item Quick Inventory of Depressive Symptomatology-Clinician Rating (QIDS-C16). A total of 76 patients completed all items and the results indicated a prevalence rate of 32% for current Axis I disorders. The QIDSSR16, QIDS-C16, and BDI-II appeared to be useful in screening for mood and anxiety disorders when compared to psychiatric disorders detected by the MINI. Anxiety disorders were found to be more common than mood disorders and also had a significant negative effect on patients' QOL. The mood disorder group, mood and anxiety disorder group, and mood disorder plus group in this study experienced a greater negative impact on QOL when compared to the Axis I group and the anxiety alone group. Based on this study and Jones et al. (2005a;b) physicians treating patients with epilepsy in tertiary care settings could expect approximately 16-24% of their patients to experience a comorbid mood disorder. Implementation of screening programs that include self-reports are effective at assisting in the clinical identification of patients with mood and/or anxiety disorders so that treatment can be initiated. These psychiatric conditions are associated with a particularly poor quality of life in patients with epilepsy. Increased attention to the presence of psychiatric conditions in patients with epilepsy is important to patient QOL.