Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, Bochum, Germany; Faculty of Health, Witten/Herdecke University, Germany.
Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, Bochum, Germany.
Epilepsy Behav. 2022 Sep;134:108857. doi: 10.1016/j.yebeh.2022.108857. Epub 2022 Jul 27.
Anxiety disorders remain undiagnosed in routine clinical practice in up to two thirds of affected patients with epilepsy despite their significant impact on medical and psychosocial outcomes. The study objective was to translate and validate the German 8-item "brief Epilepsy Anxiety Survey Instrument" (brEASI) to facilitate effective screening for the presence of anxiety disorders in German-speaking patients.
After expert translation into German, the brEASI was completed by consecutive adult inpatients with epilepsy hospitalized for seizures at an academic reference epilepsy center. Patients also completed the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), the Generalized Anxiety Disorder scale (GAD-7) for external validity, and underwent a standardized interview (Mini-DIPS-OA) as a gold standard to determine the presence of an ICD-10 anxiety disorder (generalized anxiety disorder (GAD), panic disorder, agoraphobia, and social phobia). Receiver operating characteristics (ROC) were calculated to determine the diagnostic accuracy of the brEASI, including the associated area under the curve (AUC) statistics to determine the potential of the brEASI to identify ICD-10 anxiety disorders diagnosed by interview. For comparative purposes, these analyses were also conducted for the GAD-7.
Of 80 recruited adult inpatients with epilepsy, 18 (23 %) were found to have a current anxiety disorder through standardized interview. In this study, both brEASI and GAD-7 showed a better diagnostic performance at a cutoff of >5 than at the previously reported cutoff values of >6 and >9, respectively. The AUC of the German brEASI was outstanding (AUC = 0.90, 95 % confidence interval (CI) = 0.82-0.96) for detecting all anxiety disorders and excellent for detecting non-GAD disorders (AUC = 0.85, CI = 0.76-0.92) at a cutoff of >5. At this optimal cutoff of >5 the brEASI demonstrated better sensitivity and specificity (89 % and 84 %) for identifying anxiety disorders than the GAD-7 (83 % and 74 %). The final German version of the brEASI is free to download at https://www.v-neuro.de/veroeffentlichungen/.
The German version of the brEASI represents a valid and reliable epilepsy-specific anxiety screening instrument. A positive screening result should be followed by further diagnostic procedures. Appropriate therapeutic steps should be initiated if the presence of an anxiety disorder or other psychiatric disorders is confirmed.
尽管焦虑症对医疗和心理社会结局有重大影响，但在多达三分之二的癫痫患者中，焦虑症在常规临床实践中仍未得到诊断。本研究的目的是将德国的 8 项“简要癫痫焦虑调查工具”（brEASI）翻译成德语并进行验证，以方便在德语患者中有效筛查焦虑症。
经过专家翻译成德语后，连续入组的癫痫住院患者在学术参考癫痫中心因癫痫发作而住院。患者还完成了神经障碍抑郁量表用于癫痫（NDDI-E），广泛性焦虑症量表（GAD-7）用于外部有效性，以及进行了标准化访谈（Mini-DIPS-OA）作为金标准，以确定是否存在 ICD-10 焦虑症（广泛性焦虑症（GAD）、惊恐障碍、广场恐怖症和社交恐惧症）。计算接收者操作特征（ROC）以确定 brEASI 的诊断准确性，包括相关曲线下面积（AUC）统计数据，以确定 brEASI 识别访谈诊断的 ICD-10 焦虑症的潜力。出于比较目的，还对 GAD-7 进行了这些分析。
在招募的 80 名成年癫痫住院患者中，通过标准化访谈发现有 18 名（23%）患者患有当前的焦虑症。在本研究中，与先前报告的>6 和>9 的截止值相比，brEASI 和 GAD-7 的>5 截止值均显示出更好的诊断性能。德国 brEASI 的 AUC 非常出色（AUC=0.90，95%置信区间（CI）=0.82-0.96），用于检测所有焦虑症，对于检测非 GAD 障碍非常出色（AUC=0.85，CI=0.76-0.92），截止值为>5。在这个最佳截止值>5 时，brEASI 对识别焦虑症的敏感性和特异性（89%和 84%）优于 GAD-7（83%和 74%）。brEASI 的最终德语版本可在 https://www.v-neuro.de/veroeffentlichungen/ 免费下载。
德语版 brEASI 是一种有效的、可靠的癫痫专用焦虑筛查工具。阳性筛查结果应进一步进行诊断程序。如果确认存在焦虑症或其他精神障碍，应启动适当的治疗步骤。
