Anxiety in epilepsy: a neglected disorder

Milena Gandy; Louise Sharpe; Kathryn Nicholson Perry; Laurie Miller; Zoe Thayer; Janet Boserio; Armin Mohamed

doi:10.1016/j.jpsychores.2014.12.002

Anxiety in epilepsy: a neglected disorder

J Psychosom Res. 2015 Feb;78(2):149-55. doi: 10.1016/j.jpsychores.2014.12.002. Epub 2014 Dec 9.

Authors

Milena Gandy¹, Louise Sharpe², Kathryn Nicholson Perry³, Laurie Miller⁴, Zoe Thayer⁵, Janet Boserio⁵, Armin Mohamed⁴

Affiliations

¹ The School of Psychology, University of Sydney, Australia; Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia. Electronic address: milena.gandy@mq.edu.au.
² The School of Psychology, University of Sydney, Australia.
³ University of Western Sydney, Centre for Health Research and School of Social Sciences and Psychology, Australia; Australian College for Applied Psychology, Australia.
⁴ Institute of Clinical Neurosciences, The Royal Prince Alfred Hospital, Sydney, Australia; Central Medical School, University of Sydney, Australia.
⁵ Institute of Clinical Neurosciences, The Royal Prince Alfred Hospital, Sydney, Australia.

PMID: 25541120
DOI: 10.1016/j.jpsychores.2014.12.002

Abstract

Objective: Anxiety disorders and symptoms are highly prevalent and problematic comorbidities in people with epilepsy (PWE), yet they remain poorly understood and often go undetected. This research aimed to further our understanding about anxiety in PWE.

Methods: Study 1 assessed the effectiveness of the commonly utilised yet unvalidated measure (Hospital Anxiety Depression Scale-Anxiety subscale; HADS-A) to identify DSM-IV anxiety disorders in 147 adult epilepsy outpatients.

Results: This study found that although the HADS-A had reasonable specificity (75%), its poor sensitivity (61%) and inadequate area under the curve (.68) deemed it unreliable as a screener for anxiety disorders in this population.

Methods: Study 2 aimed to further our understanding of the relationship between anxiety disorders, as defined by clinical interview, and psychosocial correlates in PWE. One hundred and twenty-two participants from Study 1 completed a battery of psychosocial measures.

Results: Multivariate analysis revealed that the presence of an anxiety disorder was associated with unemployment, which was found to be the only independent predictor. That is, despite the fact that psychosocial factors together contributed to the variance in anxiety disorders none were revealed to be significant independent predictors.

Conclusion: These findings add to the literature indicating that the HADS may indicate distress, but does not adequately identify people with anxiety disorders and highlights the urgent need for the development of a reliable anxiety screening measure for PWE. Further, the results suggest that anxiety disorders in PWE are likely to be multiply determined with respect to psychosocial factors and require further investigation.

Keywords: Anxiety; Epilepsy; Psychosocial; Risk factors; Validation.

Publication types

Research Support, Non-U.S. Gov't
Validation Study

MeSH terms

Adult
Aged
Anxiety / etiology*
Anxiety Disorders / etiology*
Area Under Curve
Employment
Epilepsy / psychology*
Female
Humans
Male
Middle Aged
Problem Solving
Psychiatric Status Rating Scales / standards*
Psychometrics
ROC Curve
Risk Factors
Self Efficacy
Sensitivity and Specificity
Social Support