Psychometric properties and diagnostic utility of the State-Trait Anxiety Inventory in epilepsy with and without comorbid anxiety disorder

Objective: Anxiety disorders are frequent comorbid disorder in patients with epilepsy ( PWEs). The availability of validated screening instruments to detect anxiety disorders in PWEs is limited. The aim of the present study was to validate State-Trait Anxiety Inventory (STAI) in adult PWEs for the detection of anxiety disorders. Methods: A total of 96 outpatients with epilepsy completed the self-report symptom scale and were diagnosed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition Text Revision (DSM-IV-TR) Axis I disorders (SCID-I). The sensitivity, specificity, positive and negative predictive values, and receiver operating characteristic (ROC) curves were assessed to determine the optimal threshold scores for the State-Trait Anxiety Inventory Slate (STAI-S) and State-Trait Anxiety Inventory Trait (STAI-T) anxiety subscales. Results: Receiver operating characteristic analyses for STAI-T showed area under the curve at 84.7%. For diagnoses of anxiety disorders, the STAI-T demonstrated the best psychometric properties for a cutoff score >= 52 with sensitivity of 81.3%, specificity of 77.5%, positive predictive value (PPV) of 41.9%, and negative predictive value (NPV) of 95.4%. Conclusions: The STAI-T proved to be a valid and reliable psychometric instrument in terms of screening for anxiety disorders in PWEs. In the epilepsy setting, STAI-T maintains adequate sensitivity, acceptable specificity, and high NPV but low PPV for diagnosing anxiety disorders with an optimum cutoff score >= 52. (C) 2019 Elsevier Inc. All rights reserved.