Anxiety in epilepsy: a neglected disorder

Area of Science:

• Neurology
• Psychiatry
• Clinical Psychology

Background:

• Anxiety disorders are common in people with epilepsy (PWE), but often go undetected.
• Understanding anxiety in PWE is crucial for improving patient care and outcomes.

Purpose of the Study:

• To evaluate the effectiveness of the Hospital Anxiety Depression Scale-Anxiety subscale (HADS-A) in identifying anxiety disorders in PWE.
• To explore the relationship between anxiety disorders and psychosocial factors in PWE.

Main Methods:

• Study 1: Assessed HADS-A's ability to detect DSM-IV anxiety disorders in 147 adult epilepsy outpatients.
• Study 2: Examined psychosocial correlates of anxiety disorders in 122 participants using clinical interviews and psychosocial measures.

Main Results:

• The HADS-A demonstrated poor sensitivity (61%) and an inadequate area under the curve (.68), deeming it unreliable for anxiety disorder screening in PWE.
• Anxiety disorders in PWE were independently associated with unemployment, despite other psychosocial factors contributing to variance.

Conclusions:

• The HADS-A may indicate general distress but is not a reliable tool for diagnosing anxiety disorders in people with epilepsy.
• There is an urgent need for a validated anxiety screening measure for PWE.
• Anxiety disorders in PWE are likely influenced by multiple psychosocial factors requiring further research.