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Lim KS, Wong KY, Chee YC, Fong SL, Yu X, Ng CG, Tang V, Lai ST, Audrey C, Shauna A, Tan CT. Feasibility of psychological screening in a tertiary epilepsy clinic. Epilepsy Behav 2023; 148:109455. [PMID: 37774547 DOI: 10.1016/j.yebeh.2023.109455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/16/2023] [Accepted: 09/17/2023] [Indexed: 10/01/2023]
Abstract
OBJECTIVE People with epilepsy (PWE) have a high prevalence of developing depression and anxiety. The objective is to determine the feasibility of brief screening tools to screen for depression and anxiety in epilepsy, and the predictive factors. METHOD This is a cross-sectional study in the neurology clinic in a tertiary teaching hospital in Kuala Lumpur. The screening tools used were the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) and the General Anxiety Disorder Form (GAD-7). RESULTS Five hundred and eighty-five patients were recruited in this study, and 50.8% of them were male, predominantly Chinese (46.7%), with a mean age of seizure onset of 21.8 ± 16.1 years. The majority had focal seizures (75.0%), and 41.9% had seizure remission. There were 15.5% who scored ≥15 in the NDDI-E, and 17.0% had moderate or severe anxiety (scored ≥10 in the GAD-7). In a regression model to predict the NDDI-E score, the age of seizure onset recorded a higher beta value (β = -0.265, p =< 0.001), followed by the duration of epilepsy (β = -0.213, p =< 0.001), use of levetiracetam (LEV) (β = 0.147, p = 0.002), clonazepam (CLZ) (β = 0.127, p = 0.011), and lamotrigine (LTG) (β = 0.125, p = 0.011), number of current antiseizure medications (β = -0.124, p = 0.049), seizure remission for ≥1 year (β = -0.108, p = 0.011), and female (β = 0.082, p = 0.049). For the GAD-7 score, the predictors included current age (β = -0.152, p = 0.001), the use of LEV (β = 0.122, p = 0.011), Indian ethnicity (β = 0.114, p = 0.006), and the use of carbamazepine (β = -0.090, p = 0.043). CONCLUSION Implementation of simple psychological screening using self-administered questionnaires was feasible in a busy tertiary epilepsy clinic.
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Affiliation(s)
- Kheng-Seang Lim
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Kian-Yong Wong
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Yong-Chuan Chee
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Si-Lei Fong
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Xuen Yu
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Chong-Guan Ng
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Venus Tang
- Department of Clinical Psychology, Prince of Wales Hospital, Hospital Authority, Hong Kong; Division of Neurosurgery, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Siew-Tim Lai
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Christine Audrey
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Aminath Shauna
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Chong-Tin Tan
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Yu Q, Ying YQ, Jiang SX, Xu ZYR, Lan MJ, Guo Y. Reliability and validation of the Chinese version of the epilepsy surgery satisfaction questionnaire. Epilepsy Behav 2023; 147:109438. [PMID: 37716327 DOI: 10.1016/j.yebeh.2023.109438] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 08/28/2023] [Accepted: 09/03/2023] [Indexed: 09/18/2023]
Abstract
OBJECTIVE To evaluate the reliability and validity the Chinese version of 19-item Epilepsy Surgery Satisfaction Questionnaire (C-ESSQ-19) in Chinese mainland patients. METHODS Patients with epilepsy who had epilepsy surgery in our hospital one year earlier were included. Internal consistency and test-retest reliability were assessed by using Cronbach alpha and intraclass correlation coefficient (ICC). Confirmatory factor analysis was used for construct validity. Discriminant validity was assessed using receiver operating characteristic curve analysis. RESULTS A total of 132 patients participated in our study, consisting of 59 females and 73 males. The C-ESSQ-19 yielded a median summary score of 86.5 (IQR=72.7-98.0). The Cronbach's alpha of the four domains of the C-ESSQ-19 ranged from 0.746 to 0.973. The test-retest reliability evaluated by ICC were good to excellent, ranging from 0.71 to 0.90 (P < 0.001). The C-ESSQ-19 demonstrated excellent construct validity, as indicated by the satisfactory goodness-of-fit of the data (SRMR = 0.046; CFI = 1.000). It exhibited acceptable discriminant validity for differentiating between patients excised or not (AUC = 0.72; 95% CI = 0.59-0.86) and self-rated severity of epilepsy (AUC = 0.76, 95% CI = 0.67-0.86), but poor discriminant validity for other factors, such as being seizure-free or not (AUC = 0.66, CI = 0.56-0.75), depressed or not (AUC = 0.66, 95% CI = 0.54-0.79), and self-rated disability related to seizures (AUC = 0.65, 95% CI = 0.50-0.80). CONCLUSIONS The C-ESSQ-19 has proven to be a reliable and valid self-rated questionnaire for assessing the satisfaction of Chinese mainland epilepsy patients with surgery.
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Affiliation(s)
- Qun Yu
- Nursing Department, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Yu-Qi Ying
- Department of Neurosurgery, the Fourth Affiliated Hospital, International Institutes of Medicine, Zhejiang University School of Medicine, Yiwu, China
| | - Si-Xuan Jiang
- Nursing Department, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Zheng-Yan-Ran Xu
- Department of Neurology, Epilepsy Center, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Mei-Juan Lan
- Nursing Department, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Yi Guo
- Department of Neurology, Epilepsy Center, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China; Department of General Practice and International Medicine, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China; Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China.
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Puteikis K, Mameniškienė R. Psychometric properties of the Lithuanian version of the NDDI-E in persons with epilepsy and suicidal ideation. Epilepsy Behav 2022; 136:108913. [PMID: 36155364 DOI: 10.1016/j.yebeh.2022.108913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 09/01/2022] [Accepted: 09/02/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Suicidality and depression are associated with worse epilepsy outcomes, but their screening in routine clinical practice remains insufficient and may improve with the validation of brief and accessible psychometric tools. We explored the psychometric properties of the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) in the Lithuanian population, which has one of the highest suicide rates globally. METHODS We conducted a cross-sectional anonymous survey among adult outpatients visiting a tertiary epilepsy clinic in Vilnius, Lithuania. People with epilepsy (PWE) provided demographic and clinical information and completed the Geriatric depression scale (GDS), the Hospital anxiety and depression scale (HADS), the Beck depression inventory (BDI), the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) and the Generalized anxiety scale-7 (GAD-7). Suicidal ideation was defined as a non-zero score on the suicide item of the BDI and clinically relevant levels of depression - as a total BDI score of >16. Psychometric properties of the NDDI-E were evaluated by measuring its internal consistency, dimensionality, correlation with other depression scales, and by conducting receiver operating characteristic analysis for the detection of suicidal ideation and symptoms of depression. RESULTS The study sample consisted of 246 PWE (average age 39.9 ± 16.3 years, 101 [41.1%] male), of them 31 (12.6%) and 41 (19.5% of those who completed the BDI) were identified with suicidal ideation or significant symptoms of depression, respectively. On average, PWE scored 10.4 ± 4.2 points on the NDDI-E. The instrument had good internal consistency (Cronbach's alpha = 0.863, n = 235), item-item and item-total correlation (>0.30). In factor analysis, its items comprised a single factor distinct from the GAD-7. The NDDI-E strongly correlated with other depression scales (r = 0.657 [GDS, n = 201], r = 0.657 [BDI, n = 201], r = 0.623 [HADS-D, n = 231], p < 0.001 for all). The NDDI-E had good diagnostic properties in discerning suicidal ideation (AUC = 0.858, 95%CI = 0.791-0.925). The isolated suicide item of the NDDI-E had acceptable properties in detecting suicidal ideation (AUC = 0.821, 95%CI = 0.724-0.918) as well. CONCLUSION The Lithuanian NDDI-E was shown to have good psychometric properties comparable to other versions of this scale. The NDDI-E is endorsed as a short and accessible instrument for estimating suicidal ideation among Lithuanian PWE.
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Affiliation(s)
| | - Rūta Mameniškienė
- Centre for Neurology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
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Lin PT, Wiebe S, Chou CC, Lu YJ, Lin CF, Hsu SPC, Lee CC, Yu HY. Validation of the Taiwanese version of the Epilepsy Surgery Satisfaction Questionnaire (Tw-ESSQ-19). Epilepsy Behav 2022; 133:108768. [PMID: 35714564 DOI: 10.1016/j.yebeh.2022.108768] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/22/2022] [Accepted: 05/20/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Satisfaction with epilepsy surgery in Mandarin-speaking countries remains unknown. We aimed to validate in our Taiwanese patients an existing instrument to measure patient satisfaction with epilepsy surgery, the 19-item Epilepsy Surgery Satisfaction Questionnaire (ESSQ-19). METHODS Consecutive patients with epilepsy who received epilepsy surgery one year earlier in Taipei Veterans General Hospital were recruited and provided clinical and demographic data. The Mandarin version of the ESSQ-19 for the Taiwanese population and eight other questionnaires were completed to assess construct validity. To evaluate the validity and reliability of the tool, the data were analyzed by confirmatory factor analysis, Spearman's rank correlation, and internal consistency analysis. RESULTS The study involved 120 patients (70 F/50 M, median age 35 years [IQR = 28-41]). The mean summary score (±SD) of the Tw-ESSQ-19 was 82.5 ± 14.5. The mean scores of the four domains were 90.3 ± 15.4 (surgical complications), 83.2 ± 16.7 (seizure control), 80.1 ± 17.3 (recovery from surgery), and 76.6 ± 18.3 (psychosocial functioning). The questionnaire was shown to have good construct validity with satisfactory goodness-of-fit of the data (standardized root mean square residual = 0.0492; comparative fit index = 0.946). It also demonstrated good discriminant validity (being seizure free [AUC 0.78; 95% CI 0.68-0.89], endorsing depression [AUC 0.84; 95% CI 0.76-0.91], self-rating epilepsy as disabling [AUC 0.71; 95% CI 0.58-0.84], and self-rating epilepsy as severe [AUC 0.78; 95% CI 0.64-0.93]), high internal consistency in four domains (Cronbach's alpha = 0.83-0.96), and no significant floor/ceiling effects of the summary score. SIGNIFICANCE The Mandarin version of the ESSQ-19 adapted for the Taiwanese population is a reliable and valid self-reported questionnaire for assessing patient satisfaction with epilepsy surgery.
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Affiliation(s)
- Po-Tso Lin
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Brain Science, Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Samuel Wiebe
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada; O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
| | - Chien-Chen Chou
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Brain Science, Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yi-Jiun Lu
- Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chun-Fu Lin
- Institute of Brain Science, Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Sanford P C Hsu
- Institute of Brain Science, Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Cheng-Chia Lee
- Institute of Brain Science, Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hsiang-Yu Yu
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Brain Science, Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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Shih YC, Chou CC, Lu YJ, Yu HY. Reliability and validity of the traditional Chinese version of the GAD-7 in Taiwanese patients with epilepsy. J Formos Med Assoc 2022; 121:2324-2330. [PMID: 35584970 DOI: 10.1016/j.jfma.2022.04.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 04/25/2022] [Accepted: 04/28/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Generalized anxiety disorder (GAD) is the second most common psychiatric comorbidity of epilepsy. GAD has a negative impact on seizure control, and it is underrecognized. The Generalized Anxiety Disorder 7-item (GAD-7) questionnaire is useful for screening GAD in patients with epilepsy (PWE). This study aimed to validate the traditional Chinese version of the GAD-7 for Taiwanese patients by obtaining data on adult PWE from our hospital. METHOD PWE were recruited from the Taipei Veterans General Hospital from April 2017 to January 2020. The mood disorder module of the Mini International Neuropsychiatric Interview (MINI) was used for the psychiatric assessment. The traditional Chinese version of the GAD-7 and the Beck Anxiety Inventory were included as self-rated psychiatric evaluation. To investigate the psychometric properties, internal consistency, external validation, and receiver operator characteristic (ROC) curve analysis were conducted to assess the utility of the Taiwanese version of the GAD-7. RESULTS We recruited 109 patients in the present study. Seventeen patients (15.9%) had GAD according to the MINI. The mean GAD-7 score was 10.28 ± 10.68. All the GAD-7 items were significantly and positively associated with the corrected overall GAD-7 score (Cronbach's alpha = 0.928, p < 0.0001). The cut-off point for the GAD-7 in ROC curve analysis was 7. The patients with GAD were more likely to be female and single. CONCLUSION The traditional Chinese version of the GAD-7 is a reliable and valid self-report questionnaire for detecting GAD in Taiwanese PWE.
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Affiliation(s)
- Yen-Cheng Shih
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan; Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Chien-Chen Chou
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan; Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Yi-Jiun Lu
- Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
| | - Hsiang-Yu Yu
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan; Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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Nassar EL, Levis B, Rice DB, Booij L, Benedetti A, Thombs BD. Inclusion of currently diagnosed or treated individuals in studies of depression screening tool accuracy: a meta-research review of studies published in 2018-2021. Gen Hosp Psychiatry 2022; 76:25-30. [PMID: 35334411 DOI: 10.1016/j.genhosppsych.2022.02.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 01/23/2022] [Accepted: 02/20/2022] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Screening is done to improve health outcomes by identifying and effectively treating individuals with unrecognized conditions. Depression screening has been proposed to identify previously unrecognized depression cases. Including individuals already diagnosed or treated for depression in screening test accuracy studies could exaggerate accuracy and the yield of new cases from screening. The present study investigated (1) the proportion of depression screening tool accuracy primary studies published in 2018-2021 that excluded individuals with a confirmed depression diagnosis or who were already undergoing treatment; and (2) whether this has improved since the last review of studies published in 2013-2015, which found that five of 89 (5.6%) primary studies appropriately excluded such individuals. METHODS MEDLINE was searched from January 1, 2018 through May 21, 2021 for primary studies on depression screening tool accuracy. RESULTS Eighteen of 106 (17.0%; 95% Confidence Interval [CI], 11.0% to 25.3%) primary studies excluded currently diagnosed or treated individuals. This was 11.4% (95% CI, 2.8% to 20.0%) greater than in similar studies published in 2013-2015. CONCLUSION There has been an improvement since 2015, but the proportion of studies that exclude individuals already known to have depression remains low. This may bias research findings intended to inform clinical practice.
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Affiliation(s)
- Elsa-Lynn Nassar
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Brooke Levis
- Centre for Prognosis Research, School of Medicine, Keele University, Staffordshire, UK
| | - Danielle B Rice
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Psychology, McGill University, Montreal, Quebec, Canada
| | - Linda Booij
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Department of Psychology, Concordia University, Montreal, Quebec, Canada; CHU Sainte-Justine Hospital Research Centre, Montreal, Quebec, Canada
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada; Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, Quebec, Canada
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Department of Psychology, McGill University, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada; Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada; Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada.
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