Abstracts

Rationale: Depression is an frequent comorbidity in patient with epilepsy (PwE) with evidence to suggest it is underdiagnosed in this patient group. Screening tools have shown to increase the dettection rate. Yet few studies have compared potentially suitable screening tools head-to-head. Methods: We enrolled 266 consecutive attendees with a confirmed diagnosis of epilepsy at a specialised neurology service in London and compared verbal and visual analogue screening tools. This included two generic depression scales (HADS, BDI-II), one custom scale (NDDI-E) and one innovative visual-analogue scale (ET). We used DSM-IV criteria for major depression and ICD-10 criteria for depressive episode as the reference standards. Results: All tools had similar overall accuracy with consistently high negative predictive value and sensitivity but more modest postitive predictive value and specificity throughout. NDDI-E performs particularly well on efficiency analysis. The accuracy of the visual analogue scale ET compared favourably with the other tools. Conclusions: We suggest that the 6-item NDDI-E should be considered if a conventional scale is needed and that the ET be considered if visual-analogue is required although we acknowledge the difficulty in extrapolating from our data to other (sub-verbal) groups. Follow up examination is necessary for all those who screen positive on any measures as these are not diagnostic tools.