PORTLAND, OR — How useful are mental health and sleep screening questionnaires for patients admitted to a seizure monitoring unit?
That is an important question, according to a study in the journal Epilepsy & Behavior, because patients with seizure disorders have generally high rates of comorbid psychological and sleep disorders.1
“Because these can profoundly affect quality of life, early recognition and treatment are of potential benefit,” explained VA Portland Health Care System-led researchers. “As a quality improvement project, we evaluated the performance and utility of a set of mental health and sleep quality screening questionnaires in patients admitted to a VA seizure monitoring unit (SMU).”
To help answer the question, the study team administered questionnaires to 100 patients admitted to the Portland VAMC SMU.
Including the:
- Beck Depression Inventory-II (BDI-II)
- Post-traumatic stress disorder (PTSD) checklist (PCL)
- Quality of Life in Epilepsy Inventory-31 (QOLIE-31)
- Pittsburgh Sleep Quality Index (PSQI)
Researchers entered scored results into the electronic medical record (EMR) within 72 hours of hospital admission, assessing how many patients exceeded questionnaire cutoff scores and whether these patients had prior mental health or sleep diagnoses or evaluations within the six months preceding admission.
After hospital discharge, providers completed a survey assessing the usefulness of the questionnaire results. The authors also reviewed EMR documented mental health and sleep visits during the six months following the SMU admission.
Results indicated that 47.5% of patients exceeded the cutoff score for the BDI-II, including 15 without an admission diagnosis of depression, and 14 who had not seen a mental health provider in the previous six months. At the same time, 33.3% of patients exceeded the cutoff score for the PCL, including nine without a diagnosis of PTSD.
“Scores on the BDI-II and PCL were highly correlated with the QOLIE-31 total score (r = 0.7,” the authors pointed out. “Seventy patients (70.7%) exceeded the cutoff score for poor sleep quality, and 37 did not have a sleep disorder diagnosis.”
As for the provider surveys, clinicians indicated that the questionnaire results were moderately or very helpful in most cases and influenced discharge recommendations to patients and referring providers in more than half of cases. EMR documented consultation were linked to discharge recommendations for mental health or sleep follow-up within the six months following SMU admission.
“The results suggest that a standard set of screening questionnaires can identify SMU patients at risk for mental health and sleep disorders, including patients not currently diagnosed or recently evaluated,” researchers conclude. “Questionnaire results were perceived as helpful by providers and influenced discharge recommendations. Given that these disorders are treatable and have a major influence on health-related quality of life, the effort to collect and document this information is well justified.”
- Salinsky M, Evrard C, Joos S, Boudreau E. Utility of mental health and sleep screening questionnaires for patients admitted to a seizure monitoring unit. Epilepsy Behav. 2021 Oct;123:108237. doi: 10.1016/j.yebeh.2021.108237. Epub 2021 Aug 7. PMID: 34375800.
