Hagemann Anne, Kuramochi Izumi, Bien Christian G, Brandt Christian
Society for Epilepsy Research, Maraweg 21, 33617 Bielefeld, Germany.
Department of Epileptology, Krankenhaus Mara, Bethel Epilepsy Center, Medical School OWL, Bielefeld University, Maraweg 21, 33617 Bielefeld, Germany.
Epilepsy Behav. 2025 Mar;164:110289. doi: 10.1016/j.yebeh.2025.110289. Epub 2025 Feb 1.
Psychiatric comorbidities are frequent in people with epilepsy (PWE) or psychogenic nonepileptic seizures (PNES), and the use of validated screening instruments to identify respective symptoms is recommended. Our aim was to investigate the recommendations resulting from routine screening for depression, anxiety and suicidality with the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) and the Generalized Anxiety Disorder Scale (GAD-7) in the outpatient clinic of a tertiary epilepsy center.
We retrospectively analyzed NDDI-E and GAD-7 scores (German versions) of 264 outpatients at a tertiary epilepsy center and extracted recommendations regarding psychopathology from the outpatient letters.
The screening revealed a likely major depression (NDDI-E ≥17) in 15.2% of PWE (without PNES, 30/197) and an NDDI-E score ≥17 in 51.2% of patients with PNES ± epilepsy (21/41), moderate to severe symptoms of generalized anxiety (GAD-7 ≥10) in 20.3% of PWE (40/197) and 56.1% of patients with PNES (23/41), and a high risk of suicidality (NDDI-E item 4 ≥3) in 8.1% of PWE (16/197) and in 24.4% of patients with PNES (10/41). The most frequently given recommendations regarding depression or anxiety were a psychiatric/psychotherapeutic treatment for PWE and an admission to the psychotherapy ward of the epilepsy center for patients with PNES. No evidence for active suicidal tendencies was found in any of the patients with a positive screening for suicidality.
Routine screening with NDDI-E and GAD-7 for depression, anxiety and suicidality is efficient and feasible and leads to individual recommendations for further assessment and treatment.
癫痫患者（PWE）或精神性非癫痫性发作（PNES）患者常伴有精神疾病共病，建议使用经过验证的筛查工具来识别相应症状。我们的目的是调查在一家三级癫痫中心门诊使用癫痫神经疾病抑郁量表（NDDI-E）和广泛性焦虑障碍量表（GAD-7）对抑郁、焦虑和自杀倾向进行常规筛查所产生的建议。
我们回顾性分析了一家三级癫痫中心264名门诊患者的NDDI-E和GAD-7评分（德文版），并从门诊信件中提取了有关精神病理学的建议。
筛查发现，15.2%的PWE（无PNES，30/197）可能患有重度抑郁症（NDDI-E≥17），51.2%的PNES±癫痫患者（21/41）的NDDI-E评分≥17；20.3%的PWE（40/197）和56.1%的PNES患者（23/41）有中度至重度广泛性焦虑症状（GAD-7≥10）；8.1%的PWE（16/197）和24.4%的PNES患者（10/41）有高自杀风险（NDDI-E第4项≥3）。关于抑郁或焦虑最常给出的建议是，PWE接受精神科/心理治疗，PNES患者入住癫痫中心的心理治疗病房。在任何自杀倾向筛查呈阳性的患者中均未发现有积极自杀倾向的证据。
使用NDDI-E和GAD-7对抑郁、焦虑和自杀倾向进行常规筛查是有效且可行的，并能产生针对进一步评估和治疗的个性化建议。
