Zilin Wang4, Zhiwen Luo3, Shunhua Li1, Zhiwen Luo3, Zilin Wang4. 1. Queen Marry School of Nanchang University, Nanchang, Jiangxi 330006, People's Republic of China. 2. Queen Marry School of Nanchang University, Nanchang, Jiangxi 330006, People's Republic of China; Affiliated Eye Hospital of Nanchang University, Jiangxi, Research Institute of Ophthalmology and Visual Science, Nanchang, People's Republic of China. 3. Queen Marry School of Nanchang University, Nanchang, Jiangxi 330006, People's Republic of China; Affiliated Eye Hospital of Nanchang University, Jiangxi, Research Institute of Ophthalmology and Visual Science, Nanchang, People's Republic of China. Electronic address: zhiwen.luo@se15.qmul.ac.uk. 4. Queen Marry School of Nanchang University, Nanchang, Jiangxi 330006, People's Republic of China. Electronic address: zilin.wang@se15.qmul.ac.uk.
Abstract
OBJECTIVE: Anxiety is a common neurological condition often comorbid with epilepsy, with approximately 20% of patients with epilepsy exhibiting symptoms of anxiety. Despite this prevalence, accurate and efficacious tools designed to screen for anxiety specifically in patients with epilepsy have not yet been developed. The purpose of this study is to systematically review the literature and better understand this relationship. METHODS: Ovid MEDLINE, EMBASE, and PsyclNFO were searched until April 22nd, 2019 without language restrictions. We extracted abstracts, data abstraction, and full-text reviews in duplicate and chose the studies that included measures for anxiety screening in patients with epilepsy. The Quality Assessment of Diagnostic Accuracy Studies Version was used to assess study quality. We used the medians and ranges to calculate the accuracy of the tools. RESULTS: We screened 4758 abstracts and selected 11 articles dealing with anxiety. The most common validated anxiety screening tools were the Generalized Anxiety Disorder (GAD-7) and Hospital Anxiety and Depression Scale-A (HADS-A). The Mini International Neuropsychiatric Interview (MINI) was the most common reference standard used. SIGNIFICANCE: Many studies have validated depression screening tools rather than anxiety. This lack of data has left much uncertainty about the relationship of epilepsy to anxiety, as well as diagnostic inconsistencies. The effectiveness of these assessments in practice may be overestimating the prevalence, as the cutpoints are usually chosen after the fact, based on the study sample.
OBJECTIVE:Anxiety is a common neurological condition often comorbid with epilepsy, with approximately 20% of patients with epilepsy exhibiting symptoms of anxiety. Despite this prevalence, accurate and efficacious tools designed to screen for anxiety specifically in patients with epilepsy have not yet been developed. The purpose of this study is to systematically review the literature and better understand this relationship. METHODS: Ovid MEDLINE, EMBASE, and PsyclNFO were searched until April 22nd, 2019 without language restrictions. We extracted abstracts, data abstraction, and full-text reviews in duplicate and chose the studies that included measures for anxiety screening in patients with epilepsy. The Quality Assessment of Diagnostic Accuracy Studies Version was used to assess study quality. We used the medians and ranges to calculate the accuracy of the tools. RESULTS: We screened 4758 abstracts and selected 11 articles dealing with anxiety. The most common validated anxiety screening tools were the Generalized Anxiety Disorder (GAD-7) and Hospital Anxiety and Depression Scale-A (HADS-A). The Mini International Neuropsychiatric Interview (MINI) was the most common reference standard used. SIGNIFICANCE: Many studies have validated depression screening tools rather than anxiety. This lack of data has left much uncertainty about the relationship of epilepsy to anxiety, as well as diagnostic inconsistencies. The effectiveness of these assessments in practice may be overestimating the prevalence, as the cutpoints are usually chosen after the fact, based on the study sample.