Estimating the diagnostic value of the Neurological Disorders Depression Inventory for Epilepsy in different languages

Adaptation of the two-item generalized anxiety disorder scale (GAD-2) to Chinese rural population: A validation study and meta-analysis

OBJECTIVE

The two-item generalized anxiety disorder scale (GAD-2) has been investigated in different populations, but with limited evaluation in the Chinese population. This study aimed to validate the diagnostic accuracy of GAD-2 for identifying GAD through a validation study along with an updated meta-analysis.

METHODS

We recruited 694 adults in 2015 from "the Henan Rural Cohort study" where the GAD-7 questionnaire was adopted as the gold standard diagnosis. Receiver operating characteristics (ROC) curve and Cronbach's α were determined. Furthermore, a meta-analysis was conducted to evaluate the effectiveness of the GAD-2.

RESULTS

In this study, 37 patients [5.33%; 95% confidence interval (CI): 3.78-7.27%] met the criteria for current GAD. The GAD-2 showed a Cronbach's alpha of 0.806 and an area under the ROC curve (AUC) of 0.954 (95% CI: 0.936-0.968). At a cutoff of 3, GAD-2 had highest Youden's index of 0.845, with a sensitivity of 0.865 and a specificity of 0.980. A total of 13 studies were included in the meta-analysis. The pooled sensitivity, specificity and diagnostic odds ratio (DOR) were 0.80, 0.82 and 17.81, respectively, at the optimal cutoff of 3.

CONCLUSION

GAD-2 has acceptable properties for identifying GAD at a cutoff of 3 in the Chinese rural population.

Validation of the Polish version of the Beck Depression Inventory in patients with epilepsy

BACKGROUND

Despite the fact that depressive disorders are the most common comorbidities among patients with epilepsy (PWE), such disorders often go unrecognized and untreated. In addition, the availability of validated screening instruments to detect depression in PWE is limited. The aim of the present study was thus to validate the Polish version of the Beck Depression Inventory (BDI) in adult PWE.

METHODS

A group of 118 outpatient PWE were invited to participate in the study. Ninety-six patients meeting the inclusion criteria completed the Polish Version of Beck Depression Inventory-I (BDI-I) and were examined by a trained psychiatrist using the Structured Clinical Interview (SICD-I) for Diagnostic and statistical manual of mental disorders - fourth edition (Text revision) (DSM-IV-TR). Receiver operating characteristic (ROC) curves were used to determine the optimal threshold scores for BDI.

RESULTS

Receiver operating characteristic analysis showed the area under the curve to be approximately 84%. For major depressive disorder (MDD) diagnosis, the BDI demonstrated the best psychometric properties for a cut-off score to be 18, with a sensitivity of 90.5%, specificity of 70.7%, positive predictive value (PPV) of 46.3%, and negative predictive value (NPV) of 96.4%. For the 'any depressive disorder' group, the BDI optimum cut-off score was 11, with a sensitivity of 82.5%, specificity of 73.2%, PPV of 68.8%, and NPV of 85.4%.

CONCLUSIONS

The BDI score is a valid psychometric indicator for depressive disorders in PWE maintaining adequate sensitivity and specificity, high NPV, and acceptable PPV with an optimum cut-off score of 18 for MDD diagnosis.

Validation of the Polish Version of the Hamilton Rating Scale for Depression in patients with epilepsy

OBJECTIVE

Depressive disorders are the most common comorbidities among patients with epilepsy (PWE). The availability of standardized clinical instruments for PWE is limited with scarce validation studies available so far. The aim of the study was to validate the Polish Version of the Hamilton Rating Scale for Depression (HRSD) in adult PWE.

METHODS

A group of 96 outpatient PWE were examined by a trained psychiatrist using the Structured Clinical Interview (SCID-I) for DSM-IV-TR and the 17-item Polish Version of HRSD (HRSD-17). Receiver operating characteristic (ROC) curves were used to determine the optimal threshold scores.

RESULTS

The ROC analyses showed areas under the curve approximately 0.9. For diagnoses of MDD, HRSD-17 demonstrated the best psychometric properties for a cutoff score of 11 with sensitivity of 100%, specificity of 89.3%, positive predictive value of 72.4%, and negative predictive value of 100%.

CONCLUSIONS

The 17-item Polish Version of HRSD proved to be reliable and valid in the epilepsy setting with a cutoff score of 11 points.

Validation of the Generalized Anxiety Disorder-7 (GAD-7) and GAD-2 in patients with migraine

Background

Psychiatric problems have been commonly reported in patients with migraine. This study investigated the reliability and validity of the Generalized Anxiety Disorder-7 (GAD-7) and Generalized Anxiety Disorder-2 (GAD-2) in patients with migraine.

Methods

Subjects were recruited from a headache clinic and a neuropsychologist examined their GAD using the Mini International Neuropsychiatric Interview-Plus Version 5.0.0 (MINI). Subjects completed several instruments, including the GAD-7, the Beck Anxiety Inventory (BAI), the Migraine Disability Assessment Scale (MIDAS), the Headache Impact Test-6 (HIT-6), and the Migraine-Specific Quality of Life (MSQoL).

Results

Among 146 participants, 32 patients (21.9 %) had GAD as determined by the MINI. Cronbach’s α for the GAD-7 and GAD-2 were 0.915 and 0.820, respectively. At a cutoff score of 5, the GAD-7 had a sensitivity of 78.1 %, a specificity of 74.6 %, a positive predictive value (PPV) of 46.3 %, and a negative predictive value (NPV) of 92.4 %. At a cutoff score of 1, the GAD-2 had a sensitivity of 84.4 %, a specificity of 72.8 %, a PPV of 46.6 %, and a NPV of 94.3 %. The scores of the GAD-7 and GAD-2 well correlated with the BAI score, the MIDAS score, the HIT-6 score, and the MSQoL score.

Conclusions

The GAD-7 and GAD-2 are both reliable and valid screening instruments for GAD in patients with migraine.

Validation of the Patient Health Questionnaire-9 (PHQ-9) and PHQ-2 in patients with migraine

Background

Psychiatric problems have been commonly reported in patients with migraine. This study investigated the reliability and validity of the Patient Health Questionnaire-9 (PHQ-9) and Patient Health Questionnaire-9 (PHQ-2) in patients with migraine.

Methods

Patients with migraine (with or without aura) were consecutively recruited from our headache clinic. They completed several instruments, including the Mini International Neuropsychiatric Interview-Plus Version 5.0.0 (MINI), the PHQ-9, the Beck Depression Inventory-II (BDI-II), the Migraine Disability Assessment Scale (MIDAS), the Headache Impact Test-6 (HIT-6), and the Migraine-Specific Quality of Life (MSQoL).

Results

Among 132 participants, 39 patients (29.5 %) had a major depressive disorder (MDD) as determined by the MINI. Cronbach’s α coefficients for the PHQ-9 and PHQ-2 were 0.894 and 0.747, respectively. At a cutoff score of 7, the PHQ-9 had a sensitivity of 79.5 %, a specificity of 81.7 %, a positive predictive value (PPV) of 64.6 %, and a negative predictive value (NPV) of 90.5 %. At a cutoff score of 2, the PHQ-2 had a sensitivity of 66.7 %, a specificity of 90.3 %, a PPV of 74.3 %, and a NPV of 86.6 %. The scores of the PHQ-9 and PHQ-2 well correlated with the BDI-II score, the MIDAS score, the HIT-6 score, and the MSQoL score.

Conclusions

The PHQ-9 and PHQ-2 are both reliable and valid screening instruments for MDD in patients with migraine.