Abstracts

Psychiatric diagnostic instruments are usually used to determine whether antiepileptic drugs (AED) or the vagus nerve stimulator (VNS) can exhibi positive psychotropic properties in epilepsy patients. Yet, in the absence of co-morbid psychiatric disorders, these instruments are unlikely to show any changes. We set-out to develop an instrument capable of identifying positive psychotropic properties of AED and the VNS in the [italic]presence or absence[/italic] of co-morbid psychiatric comorbidity.The process of developing this instrument is presented here. : We elaborated an initial self-rating questionnaire with 61 items intended to identify changes in the following domains: motivation, concentration, memory, socialization, mood and anxiety. The items were scored on a 1 to 5 Likert scale (1 = never, 2 = occasionally [1 [ndash] 2 days /week], 3 = half of the time [3 -4 days a week], 4 = majority of the time [5 [ndash] 6 days /week], 5 = all the time). Patients rated each item according to the way they felt in the previous two weeks. 53 outpatients with epilepsy from the Rush Epilepsy Center completed the questionnaire and commented on the clarity and relevance of each item. From these 61 items we eliminated any item that two or more patients rated as confusing, poorly written, irrelevant as well as items considered to screen the same properties. We selected 22 items that identified the same domains for a 98 consecutive patients with epilepsy completed the 22-item phase-2 version scale. The phase 2 scale had a good internal consistency as its Cronbach[rsquo]s alpha was 0.63. A factor analysis identified four separate factors. All, but three items were rated favorably by most patients.
We finally developed a was developed with the 19 items unanimously accepted by all patients; we added 5 new items and we started giving the 25 item scale to 100 consecutive epilepsy patient . Patients were asked to complete a self-rating scale of depression (The Beck Depression Inventory [ndash]II [BDI-II]), the Hamilton Anxiety Rating Scale (HARS), and the Adverse Event Profile (AEP), an instrument validated to identify common adverse events of AEDs, as well as the Quality of Life in Epilepsy Inventory (QOLIE-89). To date, data of 53 has been obtained. Once data are obtained from 100 consecutive patients, we will calculate a Cronbach[rsquo]s alpha, the 25 items will be submitted for a new factor analysis and the total score of our scale will be correlated with the scores of the above cited instruments for validation of our scale. At the present time, 53 patients have completed the phase 3 scale together with the BDI-II, HARS, AEP and QOLIE-89. The data gathered so far with the second-phase version indicates that an instrument to identify positive psychotropic properties of AEDs and the VNS in the absence of co-morbid psychiatric disorders have good psychometric properties. (Supported by Elan Pharmaceutical)