Characterizing screening methods and management plans among patients with anxiety or depression in epilepsy clinic

Abstract

People with epilepsy have a higher chance of developing depression and anxiety than general population. Psychiatric comorbidities in PWE are detrimental because they impact life qualities of PWE and management plans of epilepsy. Therefore, neurologists are essential for detecting anxiety and depression in PWE in outpatient clinics. Validated screening instruments including PHQ-2, PHQ-9, NDDI-E and GAD-7 can efficiently detect positive symptoms. However, they are not widely applied. There are limited studies describing screening methods and management plans in real practice. Therefore, this study was designed to characterize screening methods and describe the management plans of epilepsy providers. 565 individuals were enrolled and their demographic and clinical variables were collected. Usage of several screening methods and management plans of individuals with positive symptoms were obtained. Results showed that although PHQ-2 was the most frequently applied screening tool in outpatient clinic, it had a very low detection rate. Clinicians tended to use informal screening to identify most symptoms. Medication prescription and psychiatry referral were the two most common management plans, and the combination of those two actions resulted in the highest percentage of patients with improved symptoms. Results also indicated the potential need to adjust optimal cut points of GAD-7 and NDDI-E.