Alfredo Thomson

Screening of major depression in epilepsy: The Neurologic Depression Disorders Inventory in Epilepsy-Spanish version (Argentina)

To validate and translate the English version of the Neurologic Depression Disorders Inventory in Epilepsy (NDDI‐E) into Spanish as a screening instrument for major depressive episodes (MDE) for patients with epilepsy from Argentina and Uruguay.

Educational needs of epileptologists regarding psychiatric comorbidities of the epilepsies: a descriptive quantitative survey

Psychiatric disorders are relatively frequent comorbidities in epilepsy and they have an impact on morbidity, mortality, and quality of life. This is a report from the Task Force on Education of the ILAE Commission on Neuropsychiatry based on a survey about educational needs of epileptologists regarding management of the psychiatric comorbidities of epilepsy. The Task Force designed a quantitative questionnaire to survey the self-perceived confidence of child and adult epileptologists and psychiatrists in managing major psychiatric comorbidities of epilepsy to identify: (1) critical areas of improvement from a list of skills that are usually considered necessary for effective management of these conditions, and (2) the preferred educational format for improving these skills. A total of 211 respondents from 36 different countries participated in the survey. Confidence and usefulness scores suggest that responders would most value education and training in the management of specific clinical scenarios. Child neurologists identified major Axis I disorders, such as mood and anxiety disorders, while adult neurologists identified attention deficit hyperactivity disorder, intellectual disabilities, and autistic spectrum disorder as key areas. Both adult and child neurologists identified screening skills as the priority. Psychiatrists mainly valued specific training in the management of psychiatric complications of epilepsy surgery or psychiatric adverse events of antiepileptic drugs. Sessions during congresses and face-to-face meetings represent the preferred educational format, while e-learning modules and review papers were chosen by a minority of respondents. Results of this survey identify key areas for improvement in managing the psychiatric comorbidities of epilepsy and suggest specific strategies to develop better training for clinicians involved in epilepsy care.

In response to comments on “Screening of major depression in epilepsy: The Neurologic Depression Disorders Inventory in Epilepsy-Spanish Version (Argentina)1

To the Editors: In 2006, Gilliam et al. introduced the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) to be used as a screening tool in the outpatient neurology clinic setting. The NDDI-E is a self-administered instrument that includes six items rated on a Likert scale from “never” to “always or often.” We read with great interest the work of Thomson et al., who translated and validated the NDDI-E into Spanish for patients in Argentina and Uruguay. Despite the already validated version of NDDI-E in Spanish for patients in Spain, Thomson et al. acknowledged the significant differences in the vocabulary, idioms, and local expressions between the Spanish-speaking countries, and consequently made a second version of the Spanish NDDI-E. We strongly believe that it is important to study the diagnostic value of the NDDI-E in different languages and different dialects, as it has been shown that in different languages the cutoff points might differ slightly. Therefore, we congratulate the authors for undertaking this project. We would like, however, to highlight that the NDDI-E not only has been translated and validated in Portuguese, Japanese, Italian, and Spanish from Spain, as Thomson et al. mention in their introduction, but also has been translated and validated in German, Korean, Greek, and more recently in Arabic. We encourage clinicians to proceed to the translation and validation of the NDDI-E in other languages, as it is an excellent tool for screening for depression in epilepsy. Because it is brief and simple, it could also be used in primary care settings by clinicians who take care of patients with epilepsy once the epilepsy specialists adjust the treatment.