title: One step closer to a global tool for rapid screening of major depression in epilepsy: validation of the French NDDI-E.
abstract: OBJECTIVE
  Depression in people with epilepsy (PWE) is underdiagnosed and undertreated. The Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) is a screening questionnaire used for detecting major depressive episode (MDE) in PWE, and is already validated in 10 languages. However a version in French, one of the world's widely spoken languages, was, until now, lacking. We aimed to translate and validate the French NDDI-E.
  
  
  METHODS
  This study was performed under the auspices of the ILAE. People with epilepsy >18years of age were recruited from 2 specialist epilepsy units in Marseille, France. Two native French speakers and 2 native English speakers performed a forward-backward translation. The Mini International Neuropsychiatric Interview (MINI) was performed as the gold standard, and the Center for Epidemiological Studies Depression symptoms index (CES-D) was performed for external validity. Data were compared between PWE with MDE and PWE without MDE using the chi-square test and Student's t-test. Internal structural validity, external validity, and receiver operator characteristics were analyzed.
  
  
  RESULTS
  Testing was performed on 116 PWE: mean age=40.39years (SD=13.83, range: [18-81]years old); 58.6% (68) were women; 87.1% had focal epilepsy. Using the MINI, we found that 33 (28.4%) patients had current MDE and that 15 (12.9%) patients had dysthymia; also, we found that 37 (31.9%) patients presented suicidal ideation and/or behavior. Cronbach's alpha coefficient was 0.838, indicating satisfactory internal consistency. Correlation between the NDDI-E and the CES-D scores was high (r(116)=0.817, p<0.0001), indicating good external validity. Receiver operator characteristic analysis showed an area under the curve of 0.958 (95% CI=0.904-0.986), (p<0.0001), indicating good capacity of the NDDI-E to detect MDE (defined by MINI). The cutoff for maximal sensitivity and specificity was 15. The mean NDDI-E score in PWE with MDE was 18.27 (SD=2.28), and the mean NDDI-E score in PWE without MDE was 10.61 (SD=3.63).
  
  
  CONCLUSIONS
  This study validated the French NDDI-E, with a cutoff score of 15/24 for MDE, similar to previous studies, and reinforces the NDDI-E as a global tool for detection of MDE.
authors.affiliation: Pôle de Psychiatrie "Solaris", Centre Hospitalier Universitaire de Sainte-Marguerite, 270 Bd de Sainte-Marguerite, 13009 Marseille, France; Laboratoire de Neurosciences Cognitives, UMR CNRS 7291, 31 Aix-Marseille Université, 13331 Marseille, France.
authors.forename: Jean-Arthur
authors.initials: JA
authors.lastname: Micoulaud-Franchi
authors.affiliation: Hôpital Henri Gastaut, Etablissement Hospitalier Spécialisé dans le traitement des Epilepsies, 300 Boulevard de Sainte-Marguerite, 13009 Marseille, France.
authors.forename: Gérald
authors.initials: G
authors.lastname: Barkate
authors.affiliation: Service de Neurophysiologie Clinique, APHM, Hôpital de la Timone, 13005 Marseille, France; INSERM UMR 1106, INS, 27 Bd Jean Moulin, 13385 Marseille, France; Aix Marseille Université, Faculté de Médecine, Marseille, France.
authors.forename: Agnès
authors.initials: A
authors.lastname: Trébuchon-Da Fonseca
authors.affiliation: Service de Neurophysiologie Clinique, APHM, Hôpital de la Timone, 13005 Marseille, France; Service de Neurophysiologie Clinique, APHM, Hôpital Nord, 13015 Marseille, France.
authors.forename: Lisa
authors.initials: L
authors.lastname: Vaugier
authors.affiliation: Service de Neurophysiologie Clinique, APHM, Hôpital de la Timone, 13005 Marseille, France; INSERM UMR 1106, INS, 27 Bd Jean Moulin, 13385 Marseille, France; Aix Marseille Université, Faculté de Médecine, Marseille, France.
authors.forename: Martine
authors.initials: M
authors.lastname: Gavaret
authors.affiliation: Service de Neurophysiologie Clinique, APHM, Hôpital de la Timone, 13005 Marseille, France; INSERM UMR 1106, INS, 27 Bd Jean Moulin, 13385 Marseille, France; Aix Marseille Université, Faculté de Médecine, Marseille, France; Hôpital Henri Gastaut, Etablissement Hospitalier Spécialisé dans le traitement des Epilepsies, 300 Boulevard de Sainte-Marguerite, 13009 Marseille, France.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Bartolomei
authors.affiliation: Service de Neurophysiologie Clinique, APHM, Hôpital de la Timone, 13005 Marseille, France; INSERM UMR 1106, INS, 27 Bd Jean Moulin, 13385 Marseille, France; Aix Marseille Université, Faculté de Médecine, Marseille, France. Electronic address: aileen.mcgonigal@univ-amu.fr.
authors.forename: Aileen
authors.initials: A
authors.lastname: McGonigal
mesh_terms: D000328:Adult; D017668:Age of Onset; D000927:Anticonvulsants / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000209:etiology* / Q000523:psychology; D004827:Epilepsy / Q000150:complications* / Q000523:psychology; D005260:Female; D005602:France; D006801:Humans; D007802:Language; D008297:Male; D009483:Neuropsychological Tests; D012372:ROC Curve; D015203:Reproducibility of Results; D012959:Socioeconomic Factors; D059020:Suicidal Ideation
chemical_list: D000927:Anticonvulsants
keywords: Epilepsy; Major depressive episode; Psychiatric comorbidity; Reliability; Screening tool; Validity