Beck depression inventory (BDI) and hamilton rating scale for depression (HAM-D) in patients with epilepsy

Objective: To determine cutoff points of highest sensitivity and specificity on the Beck Depression Inventory (BDI) and Hamilton Depression Rating Scale (HAM-D) for depression diagnosis in epilepsy. Methods: Seventy-three patients from a referral center for the treatment of epilepsy underwent neuropsychiatric evaluation. We collected clinical and socio-demographic data, and applied the following instruments: Structured Clinical Interview (MINI-PLUS) for psychiatric diagnosis according to DSM-IV, HAM-D and BDI. Results: At assessment, 27.4% of the patients were depressed and 37% met diagnostic criteria for lifetime major depression. The ROC curve analysis indicated that a score > 16 on the BDI (94.4% sensitivity, 90.6% specificity) and > 16 on the HAM-D (95% sensitivity, 75.5% specificity) revealed great dichotomy between depressed and nondepressed patients. Both instruments showed a negative predictive value exceeding 95%. Conclusion: The frequency of major depression is elevated in patients with epilepsy. BDI and HAM-D can help physicians in the identification of depression in epilepsy, reducing its underdiagnosis.