Validation of the Persian NDDI-E for Depression Screening in Adolescents with Epilepsy

Depression is a prevalent comorbidity among individuals with epilepsy, significantly impacting quality of life and healthcare costs. Despite its high occurrence, depression in epilepsy often remains undiagnosed due to clinical time constraints and the lack of efficient screening tools. The Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) has demonstrated high sensitivity and specificity for detecting depression in adults with epilepsy. However, its effectiveness in adolescents remains underexplored. This study aimed to evaluate the validity and reliability of the Persian version of the NDDI-E in screening for depression among adolescents with epilepsy and to identify potential risk factors associated with depression in this population.

A cross-sectional study was conducted on 100 consecutively recruited adolescents (aged 12-18 years; 71 females, 29 males) diagnosed with epilepsy at Zahra Mardani Azari Children's Hospital. Participants completed the Persian NDDI-E, and results were compared to diagnoses obtained via the gold-standard K-SADS-PL interview administered by trained clinicians. Reliability was assessed using Cronbach's alpha, and validity was examined through sensitivity, specificity, and predictive values. Statistical analyses were performed using SPSS 26.

The NDDI-E demonstrated high sensitivity (81.48%) and specificity (95.89%) in detecting depression. Depression prevalence was 25% based on NDDI-E and 27% based on K-SADS-PL. Cronbach's alpha indicated good internal consistency (α = 0.82). A significant association was found between juvenile myoclonic epilepsy (JME) and depression, while other seizure types showed no correlation.

The Persian NDDI-E proves to be a valid and reliable screening tool for depression in adolescents with epilepsy, facilitating early detection and intervention in busy clinical settings. Routine screening is recommended to improve patient outcomes, though larger multicenter studies are needed to confirm these findings.