Psychometric properties of the Polish version of the Hamilton Anxiety Rating Scale in patients with epilepsy with and without comorbid anxiety disorder.

OBJECTIVE

Anxiety disorders (ADs) are frequent comorbid disorder in patients with epilepsy (PWE). The availability of validated screening instruments to detect AD in PWE is limited. The aim of the present study was to validate the Polish version of the Hamilton Anxiety Rating Scale (HARS) in adult PWE for the detection of AD.

METHODS

A total of 96 outpatient PWE completed the self-report symptom scale, the HARS, and were diagnosed with the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR) Axis I disorders (SCID-I). The sensitivity, specificity, positive and negative predictive value, and receiver operating characteristic (ROC) curves were assessed to determine the optimal threshold scores for the HARS.

RESULTS

Receiver operating characteristic analyses showed areas under the curve at 81.2%. For diagnoses of AD, the HARS demonstrated the best psychometric properties for a cutoff score ≥17 with sensitivity of 68.8%, specificity of 87.5%, positive predictive value of 52.4%, and negative predictive value of 93.3%.

CONCLUSIONS

The Polish version of the HARS performed moderately well as a screening instrument for ADs in PWE. In the epilepsy setting, the HARS maintains moderate sensitivity, high specificity, and excellent Negative perdictive value (NPV) but low Positive perdictive value (PPV) for diagnosing ADs with an optimum cutoff score ≥17. These results suggest that the HARS performed better to rule out anxiety, however, because of moderate sensitivity, some cases of anxiety might be missed.