Screening For Major Depression In People With Epilepsy :A Comparative Study Among NDDI-E And HRSD

Background context:High prevalence rates of depression have been found in patients with epilepsy.The biopsychosocial model has become widely adopted and.The role of psychopathology in the development and/or exacerbation of epilepsy has become increasingly recognized.and the depression brought serious negative influence to the quality of life of the patients,especially the major depression,people with epilepsy have a higher suicide rate,it great harm to patients.So its timely identification in persons with epilepsy is essential.Purpose:The use of screening tools to detect depression is common in epilepsy, The current consensus of the international clinical practice recommendations to NDDI-E for daily epileptic patients screening for depression, but the scale is not yet exam and Application in Chinese.We aimed to assess and compare the psychometric properties of the Neurological Disorders Depression Inventory for Epilepsy(NDDI-E),Hamilton Rating Scale for Depression(HRSD)as screening instruments for depression. And further evaluation of two scale for screening of epilepsy with major depressive episode boundary value.Methods:the research Methods of this paper is a retrospective analysis of medication compliance.Each patient(N=40),who is come from the First Affiliated Hospital of Dalian Medical University,is conducted by different questionnaire. These surveys include:general factors,NDDI-E,HRSD.Using the SCID-I/P as “gold standard”instrument developed for rapid diagnosis of major depressive disorder. Sensitivity, specificity, positive and negative predictive values,and areas under the ROC curves for each instrument(HRSD,NDDI-E) were determined. To evaluation whether the patients accept the scale and what the difficult degree in the clinical operation.Result:The sensitivity of NDDI-E is 0.889,the specificity of NDDI-E is 0.935,SE0.0442,the positive predictive value of NDDI-E is0.8,the negative prediction value of NDDI-E is 0.97。The sensitivity of HRSD is 0.667,the specificity of HRSD is 0.968,SE0.032,the positive predictive value of HRSD is0.857,the negative prediction value of HRSD is 0.909。Both the HRSD and the NDDI-E performed well with no significant differences in their ROC curve areas, 0.970 vs 0.966(N = 40, p =0.9177)。At the cut point of 15,the sensitivity of NDDI-E is 0.889,the specificity of NDDI-E is 0.935。Conclusion:1.The more the seizure frequency,the higher the score of the NDDI-E/HRSD;and the patient may be have the depression,if he has as more as seizures;seizure higher correlated with NDDI-E。2.The common symptom,epileptic with major depression,is psychomotor symptoms and the decline in thingking ability。3. NDDI-E is brief efficient screening instruments to identify depression in people with epilepsy. But it is not suitable for the people with low-literacy or illiteracy.It is easy to screening for major depressiong in people with epilepsy in Outpatient.4.HRSD is suitable for all the depression patient.it is have comprehensive know about psychological conditons.But it is complex and take too long. It is not easy to screening for major depressiong in people with epilepsy in Outpatient.5.NDDI-E and HRSD is reflecting similar overall test accuracy in screening for major depression in people with epilepsy.