Identifying Depressed Patients In The Neurologists Office

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Inquiry of anhedonia, that is the inability to find pleasure in most activities, is the simplest way of suspecting the existence of a depressive disorder. Second, the use of self-rating screening instruments can be of great assistance. A six-item screening instrument, the neurological disorders depression inventory for epilepsy (NDDI-E), was recently validated to screen for major depressive episodes in patients with epilepsy [14]. This instrument has the advantage of being constructed specifically to minimize confounding factors that plague other instruments, such as adverse events related to anti-epileptic drugs (AEDs) or cognitive problems associated with epilepsy. Completion of the instrument takes less than 3 min. A score of 14 or higher is suggestive of a major depressive episode and indicates that a more in-depth evaluation is necessary. Other self-rating screening instruments developed to identify symptoms of depression in the general population, such as the Beck Depression Inventory-II and the Center for Epidemiologic Studies Depression Scale, are valid instruments to screen symptoms of depression in patients with epilepsy [15]. It should be emphasized that these instruments are not diagnostic of major depressive disorders or other mood disorders; follow-up with an in-depth evaluation is necessary. Once the diagnosis of a mood disorder has been established by psychiatric evaluation, the self-rating screening instruments can be given at every visit to measure changes in symptom severity or document symptom remission.

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