Validation of the Indian version of Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) Haroon Rashid a , Jatinder Katyal a, ⁎, Manjari Tripathi b , Mamta Sood c , Yogendra K. Gupta d a Neuropharmacology Laboratory, Department of Pharmacology, All India Institute of Medical Sciences, New Delhi 110029, India b Department of Neurology, All India Institute of Medical Sciences, New Delhi 110029, India c Department of Psychiatry, All India Institute of Medical Sciences, New Delhi 110029, India d Translational Health Science and Technology Institute, Faridabad, Haryana, India abstract article info Article history: Received 14 February 2019 Accepted 28 March 2019 Available online xxxx Purpose: The Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) is an efficient tool for rapid de- tection of depression, an important comorbid condition in persons with epilepsy (PWE). Since social and cultural differences can potentially affect the cutoff score of NDDI-E, in this study, the reliability and validity of the Indian version of the NDDI-E in PWE was determined. Method: After ethical clearance, 217 PWE above 18 years of age, on antiepileptic drugs (AEDs), attending neurol- ogy outpatient department (OPD) of All India Institute of Medical Sciences (AIIMS), New Delhi, India, were eval- uated for depression using the NDDI-E (Indian version) and Mini International Neuropsychiatric Interview (MINI-Module A, version 6.0.0) as reference standard. Informed consent was taken before recruitment. Receiver operating characteristic (ROC) analysis and Cronbach's α, a measure of the internal consistency and reliability, were carried out to validate cutoff and questionnaire, respectively. Results: Of the 217 PWE (112 males/105 females), mean age of 28.6 ± 9.4 years, with generalized (69.1%) or focal seizures (30.9%), 41.5% and 10.6% were diagnosed with depression using MINI and NDDI-E Indian version (at cut- off N 15), respectively. However, at a cutoff score of N 11, the Indian version of NDDI-E had a sensitivity of 96.67%, a specificity of 84.25%, a positive predictive value of 81.31%, and a negative predictive value of 97.27%. ROC analysis showed an area under the curve (AUC) of 0.9547 (confidence interval (CI) 95% = 0.929–0.979; standard error (SE): 0.0127). With the Indian version of NDDI-E, the Cronbach's α value was 0.877. Conclusion: A periodic assessment of PWE using a quickly administrable and reliable tool for screening depression is highly desirable given the high incidence. In the Indian population with a cutoff of N 11, NDDI-E is a reliable and valid instrument to screen depression in PWE. © 2019 Elsevier Inc. All rights reserved. Keywords: Epilepsy Persons with epilepsy Antiepileptic drugs Depression MINI scale NDDI-E 1. Introduction Persons with epilepsy (PWE) have an increased risk for cognitive, behavioral, and psychosocial disorders [1] particularly major depres- sion, anxiety disorder, schizophrenia, and substance abuse [2]. Of these, depression is one of the most frequent comorbid conditions among PWE [3]. While the prevalence of depression in PWE ranges from 20% to 55% [4], prevalence of suicide in epilepsy is reported at 5– 10%, and suicidal ideation is as high as 36.7% [2]. Epilepsy and depres- sion are interlinked and lead to an increased risk of suicidal ideation and suicide. Researchers have reported a threefold increase in the diag- nosis of depression and a fourfold increase in suicide rate among PWE compared with the general population [5]. The suicidality with epilepsy (suicidal thoughts and attempts) accounts for N 10% of deaths among PWE compared with 1.4% in general population [5,6]. In spite of high prevalence, issues related to depression and suicidality in PWE are inadequately addressed. This is probably due to paucity of time and limited resources. However, in view of the relation- ship between seizure control and depression [3,7], early identification and appropriate management of depression can potentially improve seizure control as well as epilepsy-related mortality and morbidity [8]. Worldwide, many different scales have been employed for detecting depression namely, Mini International Neuropsychiatric Interview (MINI), the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (SCID), the Composite International Diag- nostic Interview (CIDI), and the Neurological Disorders Depression In- ventory for Epilepsy (NDDI-E) [9]. Among these, NDDI-E has been developed and validated against gold standard tests like SCID and MINI as an epilepsy-specific screening tool [10,11]. However, in view Epilepsy & Behavior 95 (2019) 75–78 ⁎ Corresponding author at: Department of Pharmacology, AIIMS, New Delhi, India. E-mail address: jatinderkatyal.aiims@gmail.com (J. Katyal). https://doi.org/10.1016/j.yebeh.2019.03.048 1525-5050/© 2019 Elsevier Inc. All rights reserved. Contents lists available at ScienceDirect Epilepsy & Behavior journal homepage: www.elsevier.com/locate/yebeh