School of Psychology, University of Sydney, Sydney, Australia.
Neurology. 2012 Jul 24;79(4):371-5. doi: 10.1212/WNL.0b013e318260cbfc. Epub 2012 Jul 11.
The aim of this study was to compare the efficacy of the Neurological Depressive Disorders Inventory for Epilepsy (NDDI-E) and the depression component of the Hospital Anxiety Depression Scale (HADS-D) for identifying depression and suicide risk in adults with epilepsy.
A total of 147 (87 female [59% ]) outpatients attending a tertiary epilepsy center in Sydney Australia completed the NDDI-E and HADS-D. They then completed the depression and suicide sections of the Mini International Neuropsychiatric Inventory (MINI) with a clinician blind to symptom measure scores. Receiver operator characteristic analysis was performed for the clinical cutoff scores for depression on the NDDI-E ≥ 15 and HADS-D ≥ 8 to identify MINI-determined depression and suicidality.
The NDDI-E indicated strong sensitivity (84%) and acceptable specificity (78%), whereas the HADS-D had poor sensitivity (42%) but good specificity (97%) for identifying depression. For identifying suicide risk, the NDDI-E indicated strong sensitivity (81%) and reasonable specificity (66%), whereas the HADS-D had poor sensitivity (43%) but acceptable specificity (90%). Area under the curve comparisons for these measures were not significant.
In clinical practice, it is essential that screening measures have the highest possible sensitivity values to limit the chances of false-negative results. In accordance with these guidelines, the NDDI-E was a superior screening measure compared with the HADS-D. Our results demonstrate the efficacy of the NDDI-E for identifying both major and minor depression and serious suicide risk. The poor sensitivity of the HADS-D suggests that it should not be used as a screen for depression or suicidality in adults with epilepsy.
本研究旨在比较癫痫患者神经精神障碍抑郁量表（NDDI-E）和医院焦虑抑郁量表（HADS-D）的抑郁分量表，以确定其在识别癫痫成人抑郁和自杀风险方面的作用。
澳大利亚悉尼一家三级癫痫中心的 147 名（87 名女性[59%]）门诊患者完成了 NDDI-E 和 HADS-D。然后，他们在临床医生对症状测量评分不知情的情况下，完成了迷你国际神经精神访谈（MINI）的抑郁和自杀部分。使用受试者工作特征分析对 NDDI-E≥15 和 HADS-D≥8 的临床抑郁切割值进行分析，以确定 MINI 确定的抑郁和自杀倾向。
NDDI-E 具有较强的敏感性（84%）和可接受的特异性（78%），而 HADS-D 对识别抑郁的敏感性较差（42%），特异性较好（97%）。对于识别自杀风险，NDDI-E 具有较强的敏感性（81%）和合理的特异性（66%），而 HADS-D 敏感性较差（43%），特异性可接受（90%）。这些措施的曲线下面积比较没有显著差异。
在临床实践中，筛选措施具有尽可能高的敏感性是至关重要的，以限制假阴性结果的机会。根据这些指南，NDDI-E 是一种优于 HADS-D 的筛查措施。我们的结果表明，NDDI-E 可有效识别重度和轻度抑郁以及严重自杀风险。HADS-D 的敏感性较差，提示其不应用于识别癫痫成人的抑郁或自杀倾向。
