How do we measure psychiatric diagnoses? Implications of the choice of instruments in epilepsy

Dale C. Hesdorffer*, Elisa Baldin, Rochelle Caplan, Anne T. Berg

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

27 Scopus citations

Abstract

We evaluated several commonly used screening instruments for the detection of mood disorders, anxiety disorders, and attention-deficit hyperactivity disorder (ADHD). These were compared to a criterion-based standardized questionnaire, the Diagnostic Interview Survey (DIS)-IV, designed to make DSM-IV-TR diagnoses in the community-based study of childhood-onset epilepsy. The DIS-IV was administered to young adult cases with epilepsy at a 15-year follow-up assessment and compared to symptom screens administered at the same visit, and at a previous 9-year assessment. Among cases, the specificity of the DIS-IV ranged from 0.77 to 0.99 and the predictive value of a negative psychiatric diagnosis was similarly high. Sensitivity was lower, ranging from 0 to 0.77, with correspondingly low predictive value of a positive diagnosis. Symptom-based instruments assess current symptom burden and are useful for determining associations with ongoing seizures or quality of life. Criterion-based standardized interviews, such as the DIS-IV, provide psychiatric diagnoses over the lifetime, which is most useful in studies of epilepsy genetics and studies of comorbidities and prognosis of epilepsy.

Original languageEnglish (US)
Pages (from-to)351-355
Number of pages5
JournalEpilepsy and Behavior
Volume31
DOIs
StatePublished - Feb 2014

Funding

This study was funded by a grant from the National Institutes of Health , NINDS-NS-R37-31146 . We are very grateful to all the physicians in Connecticut who have made it possible for us to recruit and follow their patients all these years. We also thank Eugene Shapiro who provided essential administrative help throughout and Drs. Susan Levy, Francine Testa, Shlomo Shinnar, and Francis DiMario, who participated in other phases of this study. This study was made possible by the generous help of the many families who have participated over the course of the last many years.

Keywords

  • Epilepsy
  • Prevalence
  • Psychiatric disorders
  • Screening instruments
  • Validity

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology
  • Behavioral Neuroscience

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