Depression screening tools in persons with epilepsy: A systematic review of validated tools

Area of Science:

• Neurology
• Psychiatry
• Diagnostic Accuracy

Background:

• Depression is highly prevalent in epilepsy patients, affecting approximately 25%.
• Establishing an optimal depression screening tool for epilepsy remains a challenge.
• Accurate depression screening is crucial for timely intervention and improved patient outcomes.

Purpose of the Study:

• To systematically review and evaluate the validity of depression-screening tools specifically in epilepsy populations.
• To identify the most effective and reliable tools for detecting depression in individuals with epilepsy.

Main Methods:

• Conducted a systematic literature search of MEDLINE, EMBASE, and PsycINFO databases.
• Included studies reporting diagnostic accuracy measures (sensitivity, specificity, predictive values) for depression-screening tools in epilepsy.
• Assessed study quality using the Quality Assessment of Diagnostic Accuracy Studies Version 2 (QUADAS-2) tool.

Main Results:

• Screened 16,070 abstracts, identifying 38 eligible articles validating 16 different screening tools across 13 languages.
• The Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) was the most frequently validated tool (n=26).
• At a cutpoint of >15, the NDDI-E demonstrated a median sensitivity of 80.5% and specificity of 86.2%.

Conclusions:

• While several depression screening tools have been validated for epilepsy, reporting of diagnostic accuracy is inconsistent.
• The NDDI-E shows promising performance, is publicly available, multi-lingual, and easy to administer.
• The optimal choice of screening tool may depend on specific clinical settings and available resources.