Budikayanti Astri, Rahmi Izati, Amalini Lilir, Lastri Diatri Nari, Prihartono Joedo, Octaviana Fitri
Department of Neurology (AB, IR, LA, DNL, FO) and Community Medicine Department (HH, JP), Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Neurol Clin Pract. 2023 Jun;13(3):e200152. doi: 10.1212/CPJ.0000000000200152. Epub 2023 May 2.
Major depressive disorder (MDD) is a common psychiatric disorder in patients with epilepsy (PWE). The Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) is one of the MDD screening tools used in PWE. This study aims to determine the accuracy of the valid and reliable NDDI-E Indonesian version as an MDD screening tool in PWE and investigate the prevalence and risk factors for the development of MDD in PWE.
A diagnostic cross-sectional study was conducted at Cipto Mangunkusumo National Referral Hospital, Indonesia. Patients were PWE aged 18 years or older who visited the epilepsy outpatient clinic. The valid and reliable NDDI-E Indonesian version and Mini International Neuropsychiatric Interview (MINI) International Classification of Disease, 10th Revision (ICD-10) were used to diagnose MDD. In phase II of the study, diagnostic accuracy was evaluated using the receiver operative characteristic (ROC) curve method to obtain the area under the curve (AUC) and diagnostic 2 x 2 table to determine the cutoff point, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). During phase III of the study, eligible individuals were screened for MDD using the NDDI-E Indonesian version. Demographic and clinical data were collected. Data analysis was performed using the χ test, Mann-Whitney test, and multivariate logistic regression analysis.
A total of 105 individuals were involved, and only 23 of them were found to experience MDD based on MINI ICD-10. The best cutoff point for the NDDI-E Indonesian version was ≥11, with a sensitivity of 91.3%, specificity 89%, PPV 70%, and NPV 97.3%. The AUC obtained from ROC analysis was 97.5% (95% CI 95-99%, < 0.001). Then, the survey was completed by 79 individuals, predominantly male, mostly within the age range of 26-45 years. The prevalence of MDD in PWE was 50.6%, and the significant risk factors were seizure frequency ≥8 times a year and the presence of chronic diseases ( < 0.001).
The NDDI-E Indonesian version was a screening tool with a high diagnostic accuracy to detect MDD in PWE at a cutoff point of 11. Poor seizure control and the presence of other chronic diseases were the risk factors correlated with MDD development in PWE.
重度抑郁症（MDD）是癫痫患者（PWE）中常见的精神疾病。癫痫神经障碍抑郁量表（NDDI-E）是用于PWE的MDD筛查工具之一。本研究旨在确定有效且可靠的NDDI-E印尼语版本作为PWE中MDD筛查工具的准确性，并调查PWE中MDD发生的患病率及危险因素。
在印度尼西亚西托·曼古库苏莫国家转诊医院进行了一项诊断性横断面研究。患者为18岁及以上前往癫痫门诊就诊的PWE。使用有效且可靠的NDDI-E印尼语版本和迷你国际神经精神访谈（MINI）国际疾病分类第10版（ICD-10）来诊断MDD。在研究的第二阶段，使用受试者工作特征（ROC）曲线方法评估诊断准确性，以获得曲线下面积（AUC），并通过诊断性2×2列联表确定截断点、敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。在研究的第三阶段，使用NDDI-E印尼语版本对符合条件的个体进行MDD筛查。收集人口统计学和临床数据。使用χ检验、曼-惠特尼检验和多因素逻辑回归分析进行数据分析。
总共纳入了105名个体，根据MINI ICD-10，其中仅23人被发现患有MDD。NDDI-E印尼语版本的最佳截断点为≥11，敏感性为91.3%，特异性为89%，PPV为70%，NPV为97.3%。从ROC分析中获得的AUC为97.5%（95%CI 95 - 99%，P < 0.001）。然后，79名个体完成了调查，以男性为主，大多年龄在26 - 45岁之间。PWE中MDD的患病率为50.6%，显著的危险因素是癫痫发作频率≥每年8次和存在慢性疾病（P < 0.001）。
NDDI-E印尼语版本是一种筛查工具，在截断点为11时对检测PWE中的MDD具有较高的诊断准确性。癫痫控制不佳和存在其他慢性疾病是与PWE中MDD发生相关的危险因素。
