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Clinical Assessment of Axis I Psychiatric Morbidity in Chronic Epilepsy: A Multicenter Investigation

Received June 24, 2003; revised December 15, 2003; accepted August 30, 2004. From the Department of Neurology, University of Wisconsin-Madison, Madison, Wisconsin; the Department of Psychiatry, Stanford University, Stanford, California; the Department of Neurology, Rush-Presbyterian St. Luke’s Medical Center, Chicago, Illinois; the Department of Neurology, Columbia University, NY, New York; and the Department of Neurology, University of Florida, Gainesville, Florida. Address correspondence to Dr. Jones, University of Wisconsin-Madison, H4/680 CSC, 600 Highland Ave., Madison, WI 53792-6180; jejones{at}neurology.wisc.edu (E-mail).

This study characterizes the rate of current Axis I DSM–IV disorders using a brief standardized psychiatric interview procedure, the Mini International Neuropsychiatric Interview (v5.0) (MINI), and determined the validity of MINI diagnoses of current depressive episodes to the research standard (Structured Clinical Interview for DSM–IV Disorders [SCID]). One hundred seventy-four patients with chronic epilepsy from five tertiary medical centers were interviewed using the MINI and the mood disorders module of the SCID. Current Axis I disorders were evident in one-half the sample (49%), with prevalent anxiety (30.4%) and mood (21.8%) disorders. Major depressive episode was the most common individual diagnosis (17.2%). Concordance was high between the MINI and SCID for diagnoses of current depression, especially for major depression. Of those with current major depression, less than one-half were treated with antidepressant medications. Current Axis I DSM–IV diagnoses can be effectively and accurately identified in clinical settings using shorter standardized psychiatric interview techniques. Issues regarding recognition and treatment of psychiatric morbidity in epilepsy are discussed.

Key Words: Epilepsy • depression • anxiety • psychiatric disorder

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