Rapid detection of generalized anxiety disorder and major depression in epilepsy: Validation of the GAD-7 as a complementary tool to the NDDI-E in a French sample
Rapid detection of generalized anxiety disorder and major depression in epilepsy: Validation of the GAD-7 as a complementary tool to the NDDI-E in a French sample
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DOI：
10.1016/j.yebeh.2016.02.015
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发表时间：
2016-04-01
影响因子：
2.6
通讯作者：
McGonigal, Aileen
中科院分区：
文献类型：
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作者：
Micoulaud-Franchi, Jean-Arthur;Lagarde, Stanislas;McGonigal, Aileen
目的：癫痫患者中广泛性焦虑障碍（GAD）的诊断和治疗不足。GAD-7是用于检测GAD的筛查问卷。然而，GAD-7作为PWE筛查工具的有用性仍有待验证。因此，我们旨在：（1）验证GAD-7在法国PWE和（2）评估其互补性方面，以前验证的抑郁症筛查工具，神经障碍抑郁量表癫痫（NDDI-E）hh.Methods：这项研究是在主持下进行的ILAE委员会神经精神病学。从法国马赛的癫痫专科招募年龄>18岁的癫痫患者。以迷你国际神经精神访谈（MINI）为金标准，宾夕法尼亚州立大学焦虑问卷（PSWQ）和NDDILE为外部效度。使用卡方检验和Student’s L-Lest比较PWE伴/不伴GAD的数据。内部结构效度，外部效度，和接收操作员的特点进行了分析。对GAD-7（7项）和NDDI-E（6项）的13个项目进行方差最大旋转的主成分因子分析。结果：对145名PWE进行了测试：平均年龄= 39.38岁（SD = 1401，范围：18-75）; 63.4%（92）女性; 75.9%患有局灶性癫痫。使用MINI，49例（33.8%）患者目前患有GAD。Cronbach α系数为0.898，表明内部一致性令人满意。GAD-7与PSQW评分之间的相关性很高（r（145）= .549，P-D 001），表明外部效度良好。因子分析结果表明，焦虑和抑郁两个因子在GAD-7和NDDI-E量表上的反映不同。受试者操作特征分析显示曲线下面积为0.899（95%CI 0.838-0943，P < 0.0001），表明GAD-7检测GAD（由MINI定义）的良好能力。最大灵敏度和特异性的临界值为7。在PWE中，有GAD的平均GAD-7评分为13.22（SD 3.99），而没有GAD的平均GAD-7评分为5.17（SD 4.66）。意义：本研究验证了法语版本的GAD-7筛查工具用于PWE中的广泛性焦虑，GAD的截止评分为7;21，并且还证实了GAD-7是一种简短且易于管理的Lest。因子分析显示，GAD-7（广泛性焦虑障碍筛查）和NDDI-E（重性抑郁症筛查）提供了互补的信息。GAD-7和NDDI-E的常规应用在癫痫患者的临床评估中应予以考虑。(C)2016 Elsevier Inc. All rights reserved.
Objective: Generalized anxiety disorder (GAD) in people with epilepsy (PWE) is underdiagnosed and undertreated. The GAD-7 is a screening questionnaire to detect GAD. However, the usefulness of the GAD-7 as a screening tool in PWE remains to be validated. Thus, we aimed to: (1) validate the GAD-7 in French PWE and (2) assess its complementarity with regard to the previously validated screening tool for depression, the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E).Methods: This study was performed under the auspices of the ILAE Commission on Neuropsychiatry. People with epilepsy >18 years of age were recruited from the specialist epilepsy unit in Marseille, France. The Mini-International Neuropsychiatric Interview (MINI) was performed as gold standard, and the Penn State Worry Questionnaire (PSWQ) and the NDDILE were performed for extemal validity. Data were compared between PWE with/without GAD using Chi2 Lest and Student's L-Lest. Internal structural validity, external validity, and receiver operator characteristics were analyzed. A principal component factor analysis with Varimax rotation was performed on the 13 items of the GAD-7 (7 items) plus the NDDI-E (6 items).Results: Testing was performed on 145 PWE: mean age = 39.38 years old (SD = 1401, range: 18-75); 63.4% (92) women; 75.9% with focal epilepsy. Using the MINI, 49 (33.8%) patients had current GAD. Cronbach's alpha coefficient was 0.898, indicating satisfactory internal consistency. Correlation between GAD-7 and the PSQW scores was high (r (145) = .549, P- D001), indicating good external validity. Factor analysis shows that the anxiety investigated with the GAD-7 and depression investigated with the NDDI-E reflect distinct factors. Receiver operator characteristic analysis showed area under the curve of 0.899 (95% CI 0.838-0943, P < 0.0001) indicating good capacity of the GAD-7 to detect GAD (defined by MINI). Cutoff for maximal sensitivity and specificity was 7. Mean GAD-7 score in PWE with GAD was 13.22 (SD 3.99), and that without GAD was 5.17 (SD 4.66).Significance: This study validates the French language version of the GAD-7 screening tool for generalized anxiety in PWE, with a cutoff score of 7;21 for GAD, and also confirms that the GAD-7 is a short and easily administered Lest. Factor analysis shows that the GAD-7 (screening for generalized anxiety disorder) and the NDDI-E (screening for major depression) provide complementary information. The routine use of both GAD-7 and NDDI-E should be considered in clinical evaluation of patients with epilepsy. (C) 2016 Elsevier Inc. All rights reserved.