Due to the high prevalence of depression and anxiety in people with epilepsy, the International League Against Epilepsy Commission on the Neuropsychiatric Aspects of Epilepsy recommends implementing routine screening for depression and anxiety symptoms. Our epilepsy group began administering three screening questionnaires to all clinic patients in 2016: the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), the Beck Anxiety Inventory (BAI) and the Generalized Anxiety Disorder-7 (GAD-7).

We aim to review our experience with this screening approach.

We reviewed 2253 sets of questionnaires completed from January 2018 to March 2020 and studied the actions taken by epileptologists in response to a positive screening.

Thirty-six percent of all assessed patients screened positive on at least one questionnaire: 13.6% screened positive for depression symptoms (NDDI-E ≥ 16), 12.3% for anxiety symptoms (BAI ≥ 22) and 30.3% for GAD symptoms (GAD-7 > 7). Among patients with a positive screening, 36% received a care intervention, 59% did not and 5% declined the neurologist’s recommendation. Among patients for whom an intervention was implemented, 58% were referred to a mental health professional (generally a neuropsychiatrist), 29% had their antiseizure medication adjusted to alleviate their symptoms and 13% received another intervention.

In our clinic, an important proportion of patients screened positive for depression and/or anxiety symptoms. Fewer than half received a management option to alleviate their symptoms. We conclude that while routine screening increases the detection of depression and anxiety among epilepsy patients, it must be accompanied by effective interventions and access to mental-health professionals.

Awareness of attention deficit hyperactivity disorder (ADHD) in adults has been growing over the last decade. One of the most interesting issues related to this topic is these adults’ self-awareness of their ADHD symptoms and their estimation of their own impairments. Our hypothesis while studying young adult ADHD populations was that there would be a significant difference between their self-report and their clinical assessment.

One hundred and three students volunteered for this study. In order to validate our ADHD screening questionnaire (ADHD-SQ), and to assess the level of awareness they have of their own symptoms, participants underwent a complete clinical assessment for ADHD. They were divided into a control group (n = 24), and an ADHD study group (n = 79), which in turn was composed of two sub-groups, one comprising 24 ADHD predominantly inattentive (ADHD-I) and the other 55 ADHD combined type (ADHD-C).

Factor analysis yielded two factors explaining 41% of the variance. The Inattention (IA) subscale score tended to be higher in both ADHD sub-groups as compared to the control group (6.5±2.1 vs. 2.34±2.3 with P<0.001), with no significant difference between the two ADHD sub-groups. Hyperactivity Impulsivity (HI) subscale was significantly higher for the ADHD-C sub-group than in the ADHD-I sub-group, whose score was similar to that of the control group (control: 1.6±2.1; ADHD-I: 1.55±1.0; ADHD-C: 4.5±2.6, P<0.0001). Receiver Operating Characteristics (ROC) analysis showed similar results. The area under the curve (AUC) of IA subscale score was 0.90 (95% confidence: 0.83–0.96) and for HI subscale score was 0.75, (95% confidence: 0.63–0.86). Classification into groups used a cut-off point of 3+ items out of nine, in the SQ and 6+ items out of nine in the clinical assessment. These two classifications showed 68% agreement (46% sensitivity and 95% specificity). In both ADHD sub-groups, the self-reported average number of positive symptoms per student was relatively low for both clusters; this phenomenon was pronounced in the specific subtypes. The self-rated HI cluster score was considerably low in the ADHD-C sub-group (4.5±2.6), and the IA one was particularly low in the ADHD-IADHD-I sub-group (5.9±1.9).

This study's results indicate that ADHD symptoms are under-reported for both inattentive and hyperactive-impulsive clusters, indicating that adults with ADHD tend to under-estimate their own ADHD-related impairments. We suggest that this questionnaire may be used both in research and academic settings to help counsellors and students to obtain early indication of ADHD and to refer students suspected of having ADHD to full clinical assessment.