Abstract
Objective
Clinical guidelines recommend screening people with epilepsy (PWE) regularly for mental
distress, but it is unclear how guidelines are implemented. We surveyed epilepsy specialists
in adult Scottish services to determine approaches used to screen for anxiety, depression,
and suicidality; the perceived difficulty of screening; factors associated with intention
to screen; and treatment decisions made following positive screens.
Methods
An anonymous email-based questionnaire survey of epilepsy nurses and epilepsy neurology
specialists (n = 38) was conducted.
Results
Two in every three specialists used a systematic screening approach; a third did not.
Clinical interview was employed more often than standardized questionnaire. Clinicians
reported positive attitudes towards screening but found screening difficult to implement.
Intention to screen was associated with favorable attitude, perceived control, and
social norm. Pharmacological and non-pharmacological interventions were proposed equally
often for those screening positive for anxiety or depression.
Conclusion
Routine screening for mental distress is carried out in Scottish epilepsy treatment
settings but is not universal. Attention should be paid to clinician factors associated
with screening, such as intention to screen and resulting treatment decisions. These
factors are potentially modifiable, offering a means of closing the gap between guideline
recommendations and clinical practice.
Keywords
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Article info
Publication history
Published online: March 30, 2023
Accepted:
March 16,
2023
Received in revised form:
March 16,
2023
Received:
February 20,
2023
Identification
Copyright
© 2023 Elsevier Inc. All rights reserved.
