Abstract | PURPOSE: This study aimed to evaluate the diagnostic accuracy of the Hamilton Rating Scale for Depression (HRSD), the Beck Depression Inventory (BDI), the Hospital Anxiety and Depression Scale ( HADS), and the Hospital Anxiety and Depression Scale-Depression subscale ( HADS-D) as diagnostic tests for depressive disorder in drug-resistant mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS). METHODS: One hundred three patients with drug-resistant MTLE-HS were enrolled. All patients underwent a neurological examination, interictal and ictal video-electroencephalogram (V-EEG) analyses, and magnetic resonance imaging (MRI). Psychiatric interviews were based on DSM-IV-TR criteria and ILAE Commission of Psychobiology classification as a gold standard; HRSD, BDI, HADS, and HADS-D were used as psychometric diagnostic tests, and receiver operating characteristic (ROC) curves were used to determine the optimal threshold scores. RESULTS: For all the scales, the areas under the curve (AUCs) were approximately 0.8, and they were able to identify depression in this sample. A threshold of ≥9 on the HRSD and a threshold of ≥8 on the HADS-D showed a sensitivity of 70% and specificity of 80%. A threshold of ≥19 on the BDI and HADS-D total showed a sensitivity of 55% and a specificity of approximately 90%. The instruments showed a negative predictive value of approximately 87% and a positive predictive value of approximately 65% for the BDI and HADS total and approximately 60% for the HRSD and HADS-D. CONCLUSIONS: HRSD≥9 and HADS-D≥8 had the best balance between sensitivity (approximately 70%) and specificity (approximately 80%). However, with these thresholds, these diagnostic tests do not appear useful in identifying depressive disorder in this population with epilepsy, and their specificity (approximately 80%) and PPV (approximately 55%) were lower than those of the other scales. We believe that the BDI and HADS total are valid diagnostic tests for depressive disorder in patients with MTLE-HS, as both scales showed acceptable (though not high) specificity and PPV for this type of study.
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Authors | Bianca de Lemos Zingano, Ricardo Guarnieri, Alexandre Paim Diaz, Marcelo Liborio Schwarzbold, Maria Alice Horta Bicalho, Lucia Sukys Claudino, Hans J Markowitsch, Peter Wolf, Katia Lin, Roger Walz |
Journal | Epilepsy & behavior : E&B
(Epilepsy Behav)
Vol. 50
Pg. 61-6
(Sep 2015)
ISSN: 1525-5069 [Electronic] United States |
PMID | 26119622
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Validation Study)
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Copyright | Copyright © 2015 Elsevier Inc. All rights reserved. |
Topics |
- Adult
- Depressive Disorder
(diagnosis, epidemiology, psychology)
- Diagnostic Tests, Routine
(standards)
- Diagnostic and Statistical Manual of Mental Disorders
- Drug Resistant Epilepsy
(diagnosis, epidemiology, psychology)
- Epilepsy, Temporal Lobe
(diagnosis, epidemiology, psychology)
- Female
- Humans
- Male
- Middle Aged
- Personality Inventory
(standards)
- Psychiatric Status Rating Scales
(standards)
- Reproducibility of Results
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