Screening and diagnosis for mood and anxiety disorders in epilepsy: Polish population reference values

Abstract

Introduction: Epilepsy is one of the world's most prevalent noncommunicable diseases and tends to have a chronic course, often with comorbid psychiatric disorders, of which depressive disorders (DDs) and anxiety disorders (ADs) are the most common.

Background: As anxiety and depressive disorders are underdiagnosed and so undertreated in people with epilepsy (PWE), this could have implications for the course of both of these medical conditions and the response to treatment and health outcomes. Thus it is crucial to perform screening for psychiatric disorders in populations with epilepsy using specific psychometric screening instruments optimised for that group of patients. Polish versions of the Hospital Anxiety and Depression Scale (HADS), the Hamilton Rating Scale for Depression (HRSD), the Hamilton Anxiety Rating Scale (HARS), the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI) and the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) were validated against 'gold standards' in a Polish population with epilepsy.

Clinical implications: Using well-validated screening instruments that can be easily implemented in a clinical setting may contribute to better diagnosis, and consequently treatment, of comorbid psychiatric disorders, which would have a great impact on the course and prognosis of epilepsy management.

Conclusions: Based on the outcomes of Polish studies aimed at validating psychometric instruments for screening for mood and anxiety disorders, HADS is recommended as a first-choice screening tool.

Keywords: anxiety disorders; epilepsy; mood disorders; screening tools.