Identifying depression in epilepsy in a busy clinical setting is enhanced with systematic screening

Abstract Purpose Depression is a highly prevalent, relatively underdiagnosed and undertreated comorbid condition in epilepsy. The purpose of this study was to determine the effect of using a validated self-reporting depression scale on the ability to detect depression in people with epilepsy receiving care in a busy clinical setting. Methods The Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) is a 6-item questionnaire validated to screen for depression in people with epilepsy. We performed a retrospective chart review of 192 consecutive patients who had completed the NDDI-E while receiving care at a seizure clinic in the largest public hospital in Houston, Texas. For comparison, charts of 192 consecutive patients receiving care immediately prior to the implementation of the NDDI-E in the same clinic were assessed. Results Fifty-five (28.6%) of patients screened positive for depression with the NDDI-E. They subsequently received a semi-structured psychiatric interview based on the DSM-IV model and 89% ( n =49) were confirmed to have major depression. Use of the NDDI-E thus resulted in the detection of active depression in 25.5% ( n =49) of the patients, whereas only 2.6% ( n =5) of patients in the group not systematically screened were found to have active depression ( p Discussion Use of the NDDI-E significantly improved the ability to detect depression in epilepsy patients in a busy clinical practice.