title: Combined detection of depression and anxiety in epilepsy patients using the Neurological Disorders Depression Inventory for Epilepsy and the World Health Organization well-being index.
abstract: OBJECTIVE
  To validate the Danish version of the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), and compare it with the World Health Organization index for psychological well-being (WHO-5) as screening tests for depression and anxiety in epilepsy patients.
  
  
  METHODS
  Epilepsy outpatients filled out NDDI-E and WHO-5. A Mini International Neuropsychiatric Interview (MINI) as gold standard for psychiatric diagnoses was carried out with every patient.
  
  
  RESULTS
  We included 124 epilepsy patients. According to MINI, 5% had depression without anxiety, 6% anxiety without depression, and 6% had both. For the detection of depression, NDDI-E was slightly better than WHO-5. With a score of more than 13, NDDI-E as a screening tool for depression had a sensitivity of 0.92, a specificity of 0.84, a positive predictive value (PPV) of 0.40, and a negative predictive value (NPV) of 0.99. In the detection of anxiety WHO-5 was better than NDDI-E. With a score below 50, WHO-5 as screening for anxiety had a sensitivity of 0.80, a specificity of 0.92, PPV 0.57, and NPV 0.97. When combining NDDI-E>13 and WHO-5<50, 95% of patients with depression and/or anxiety are identified, and in addition there are 17% false positives.
  
  
  CONCLUSIONS
  NDDI-E in Danish is valid and slightly better than WHO-5 in the detection of depression in epilepsy patients. WHO-5 is valid for the detection of anxiety disorders. Combined use of NDDI-E and WHO-5 is recommended, since 95% of all epilepsy patients with depression and/or anxiety disorder are identified with only a modest number of false positives.
authors.affiliation: Copenhagen University Hospital of North Zealand, Department of Neurology, Dyrehavevej 29, DK-3400 Hillerød, Denmark. Electronic address: Christian.pilebaek.hansen.01@regionh.dk.
authors.forename: Christian Pilebæk
authors.initials: CP
authors.lastname: Hansen
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
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000175:diagnosis* / Q000209:etiology*; D003863:Depression / Q000175:diagnosis* / Q000209:etiology*; D004827:Epilepsy / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination / Q000379:methods; D011569:Psychiatric Status Rating Scales; D012372:ROC Curve; D012016:Reference Values; D014944:World Health Organization
keywords: Anxiety; Depression; Epilepsy; MINI; NDDI-E; WHO-5