title: Anxiety in epilepsy: a neglected disorder.
abstract: OBJECTIVE
  Anxiety disorders and symptoms are highly prevalent and problematic comorbidities in people with epilepsy (PWE), yet they remain poorly understood and often go undetected. This research aimed to further our understanding about anxiety in PWE.
  
  
  METHODS
  Study 1 assessed the effectiveness of the commonly utilised yet unvalidated measure (Hospital Anxiety Depression Scale-Anxiety subscale; HADS-A) to identify DSM-IV anxiety disorders in 147 adult epilepsy outpatients.
  
  
  RESULTS
  This study found that although the HADS-A had reasonable specificity (75%), its poor sensitivity (61%) and inadequate area under the curve (.68) deemed it unreliable as a screener for anxiety disorders in this population.
  
  
  METHODS
  Study 2 aimed to further our understanding of the relationship between anxiety disorders, as defined by clinical interview, and psychosocial correlates in PWE. One hundred and twenty-two participants from Study 1 completed a battery of psychosocial measures.
  
  
  RESULTS
  Multivariate analysis revealed that the presence of an anxiety disorder was associated with unemployment, which was found to be the only independent predictor. That is, despite the fact that psychosocial factors together contributed to the variance in anxiety disorders none were revealed to be significant independent predictors.
  
  
  CONCLUSIONS
  These findings add to the literature indicating that the HADS may indicate distress, but does not adequately identify people with anxiety disorders and highlights the urgent need for the development of a reliable anxiety screening measure for PWE. Further, the results suggest that anxiety disorders in PWE are likely to be multiply determined with respect to psychosocial factors and require further investigation.
authors.affiliation: The School of Psychology, University of Sydney, Australia; Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia. Electronic address: milena.gandy@mq.edu.au.
authors.forename: Milena
authors.initials: M
authors.lastname: Gandy
authors.affiliation: The School of Psychology, University of Sydney, Australia.
authors.forename: Louise
authors.initials: L
authors.lastname: Sharpe
authors.affiliation: University of Western Sydney, Centre for Health Research and School of Social Sciences and Psychology, Australia; Australian College for Applied Psychology, Australia.
authors.forename: Kathryn Nicholson
authors.initials: KN
authors.lastname: Perry
authors.affiliation: Institute of Clinical Neurosciences, The Royal Prince Alfred Hospital, Sydney, Australia; Central Medical School, University of Sydney, Australia.
authors.forename: Laurie
authors.initials: L
authors.lastname: Miller
authors.affiliation: Institute of Clinical Neurosciences, The Royal Prince Alfred Hospital, Sydney, Australia.
authors.forename: Zoe
authors.initials: Z
authors.lastname: Thayer
authors.affiliation: Institute of Clinical Neurosciences, The Royal Prince Alfred Hospital, Sydney, Australia.
authors.forename: Janet
authors.initials: J
authors.lastname: Boserio
authors.affiliation: Institute of Clinical Neurosciences, The Royal Prince Alfred Hospital, Sydney, Australia; Central Medical School, University of Sydney, Australia.
authors.forename: Armin
authors.initials: A
authors.lastname: Mohamed
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000209:etiology*; D001008:Anxiety Disorders / Q000209:etiology*; D019540:Area Under Curve; D004651:Employment; D004827:Epilepsy / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011340:Problem Solving; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D011594:Psychometrics; D012372:ROC Curve; D012307:Risk Factors; D020377:Self Efficacy; D012680:Sensitivity and Specificity; D012944:Social Support
keywords: Anxiety; Epilepsy; Psychosocial; Risk factors; Validation