title: The interictal dysphoric disorder in patients with epilepsy: A doubtful disorder lacking diagnostic tools.
abstract: OBJECTIVE
  To examine adult epilepsy outpatients for the existence of the interictal dysphoric disorder (IDD) using the interictal dysphoric disorder inventory (IDDI), the overlap between IDD, depression, and anxiety, and the reproducibility of IDDI.
  
  
  METHODS
  Epilepsy outpatients were assessed with the Danish IDDI and self-report inventories for depression and anxiety. Patients with abnormal scores were further assessed with the Mini International Neuropsychiatric Interview (MINI). Patients with IDD were asked to repeat IDDI for evaluating the reproducibility. Quality of life, well-being and adverse effects to antiepileptic drugs were determined.
  
  
  RESULTS
  We included 169 patients, and 32 (19%) were diagnosed with IDD. Thirty patients were further assessed with MINI, and 17 (57%) were diagnosed with additional psychiatric disorders, mainly depression, dysthymia, and anxiety. Patients with IDD and additional psychiatric comorbidity had significantly higher seizure frequency, higher level of side effects to the antiepileptic treatment, and lower quality of life, both when compared to patients with normal screening and patients with IDD as the only comorbidity. The reproducibility of the Danish IDDI was only 50%.
  
  
  CONCLUSIONS
  With a prevalence of 19%, IDD appeared to be the commonest neuropsychiatric syndrome. The majority of the patients with IDD also had depressive and/or anxiety disorders. Quality of life, seizure control, and side effects to antiepileptic drugs were affected much more by depression or anxiety, than by IDD. The Danish version of IDDI has a poor reproducibility. The existence of IDD as a diagnostic entity is doubtful.
authors.affiliation: Copenhagen University Hospital of North Zealand, Department of Neurology, Dyrehavevej 29, DK-3400 Hillerød, Denmark.
authors.forename: Moshgan
authors.initials: M
authors.lastname: Amiri
authors.affiliation: Copenhagen University Hospital of North Zealand, Department of Neurology, Dyrehavevej 29, DK-3400 Hillerød, Denmark. Electronic address: christian.pilebaek.hansen@regionh.dk.
authors.forename: Christian Pilebæk
authors.initials: CP
authors.lastname: Hansen
mesh_terms: D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use; D016009:Chi-Square Distribution; D004827:Epilepsy / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology*; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012720:Severity of Illness Index
chemical_list: D000927:Anticonvulsants
keywords: Anxiety; Depression; Epilepsy; Interictal Dysphoric Disorder Inventory; Interictal dysphoric disorder; Quality of life