Patient-reported outcome measures in persons with epilepsy - Part I: detection of depression and anxiety

This review examines patient-reported outcome measurements (PROMs) for assessing anxiety and depressive disorders in adults with epilepsy. These are comorbidities that critically affect quality of life and epilepsy management. We identified potential PROMs by literature research. Most tools for assessing depression are generic instruments, primarily designed for the general population or individuals without chronic conditions. Although later validated for people with epilepsy (PWE), most of them are not optimally suited for an overall depression assessment. Even fewer were specifically developed for epilepsy populations, most prominently the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), requiring careful implementation and result interpretation. Similarly, there are just a few instruments that provide a broader evaluation of anxiety and reliably measure general anxiety symptoms in epilepsy. Although some tools were validated for epilepsy populations, they were also not tailored to the unique concerns in epilepsy populations, potentially biasing the results. However, compared to depression, certain epilepsy-specific anxiety assessment tools could be identified that refer directly to specific and more nuanced fears relevant for PWE and are less confounded than general anxiety and depression tools. Key aspects of each instrument are analyzed, suggesting their clinical applicability in epilepsy care with a focus on context- and epilepsy-specific strengths and limitations for their use. The findings demonstrate the importance of PROMs for the identification and treatment of psychiatric comorbidities in PWE to support patient-centered care and improve clinical outcomes. The review also highlights the urgent need for epilepsy-specific PROMs that reflect the unique psychosocial challenges of this population.