Validation of the generalized anxiety disorder scales (GAD-7 and GAD-2) in primary care settings in Latvia (original) (raw)
Related papers
Health and Quality of Life Outcomes, 2012
Aim: To psychometrically validate the Spanish version of the self-administered 2-item GAD-2 scale for screening probable patients with generalised anxiety disorder (GAD). Methods: The GAD-2 was self-administered by patients diagnosed with GAD according to DSM-IV criteria and by age-and sex-matched controls who were recruited at random in mental health and primary care centres. Criteria validity was explored using ROC curve analysis, and sensitivity, specificity and positive and negative predictive values were determined for different cut-off values. Concurrent validity was also established using the HAM-A, HADS, and WHODAS II scales. Results: The study sample consisted of 212 subjects (106 patients with GAD) with a mean age of 50.38 years (SD = 16.76). No items of the scale were left blank. Floor and ceiling effects were negligible. No patients with GAD had to be assisted to complete the questionnaire. Reliability (internal consistency) was high; Cronbach's α = 0.875. A cut-off point of 3 showed adequate sensitivity (91.5%) and specificity (85.8%), with a statistically significant area under the curve (AUC = 0.937, p < 0.001), to distinguish GAD patients from controls. Concurrent validity was also high and significant with HAM-A (0.806, p < 0.001), HADS (anxiety domain, 0.825, p < 0.001) and WHO-DAS II (0.642, p < 0.001) scales. Conclusion: The Spanish version of the GAD-2 scale has been shown to have appropriate psychometric properties to rapidly detect probable cases of GAD in the Spanish cultural context under routine clinical practice conditions.
Screening for generalized anxiety disorder in Spanish Primary Care Centers with the GAD 7
Psychiatry Research, 2017
The aim of the study was to determine the criterion validity of a computerized version of the General Anxiety Disorder-7 (GAD-7) questionnaire to detect general anxiety disorder in Spanish primary care centers. A total of 178 patients completed the GAD-7 and were administered the Composite International Diagnostic Interview (CIDI) for DSM-IV Axis I Disorders, which was used as a reference standard. Sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios were calculated. A cut-off of 10 yielded a sensitivity of .87, a specificity of .78, a positive predictive value of .93, a negative predictive value of .64, a positive likelihood ratio of 3.96 a negative likelihood ratio of .17 and Younden's Index of .65. The GAD-7 performed very well with a cut-off value of 10, the most frequently used cut-off point. Thus, a computerized version of the GAD-7 is an excellent screening tool for detecting general anxiety disorder in Spanish primary care settings.
Journal of Affective Disorders, 2011
Objective: To explore the validity of the GAD-7 scale as an outcome measure of disability in primary care. Methods: A random sample of 212 subjects was recruited in primary care clinics; 50% diagnosed with generalized anxiety disorder (GAD) by DSM-IV criteria and 50% concurrent matched controls. The GAD-7, the Hamilton Anxiety Scale (HAM-A), and the abridged 12-item version of World Health Organization Disability Scale (WHO-DAS-II) were administered. The number of visits to primary care and specialty clinics was also recorded. Results: Strong and significant (pb 0.001) correlations were found between GAD-7 and HAM-A (r = 0.852) and WHO-DAS-II (r = 0.704) scores, particularly for Participation in Society (r = 0.741), Understanding and Communication (r = 0.679), and Life Activities (0.638) dimensions. Moderate but significant correlations were also found between GAD-7 score and the number of visits to Primary Care (r= 0.393) and Specialty clinics (r= 0.373). In all cases, an overall relation was observed between GAD-7 severity levels and disability scores [F (3,208) = 25.4, p b 0.001] as assessed by the WHO-DAS II, with higher mean disability values related to higher severity levels. Conclusions: The GAD-7 scale has been shown to highly correlate not only with specific anxiety but also with disability measures. It has been shown that more severe GAD levels correlate with higher disability states and tend to demand more health care attention. As the GAD-7 is self-administered and is not time consuming, this instrument could be a good choice to explore the level of patient disability in subjects with GAD in primary care settings.
Validation of the GAD-7 (Malay version) among women attending a primary care clinic in Malaysia
Journal of primary health care, 2012
Anxiety is a common mental health disorder in primary care, with a higher prevalence among women compared to men. This is the first study to validate the Generalised Anxiety Disorder-7 questionnaire (GAD-7) as a case-finding instrument for anxiety in a primary care setting in Malaysia. The objective was to determine the diagnostic accuracy of the Malay version of the GAD-7 in detecting anxiety among women. This cross-sectional study was conducted in a government-funded primary care clinic in Malaysia. Consecutive women participants attending the clinic during data collection were given self-administered questionnaires including the GAD-7 (Malay version). Participants then were selected using systematic weighted random sampling for Composite International Diagnostic Interviews (CIDI). The GAD-7 was validated against the CIDI reference standard. The response rate was 87.5% for the questionnaire completion (895/1023), and 96.8% for diagnostic interviews (151/156). The prevalence of anx...
Journal of Affective Disorders, 2019
Background: The Generalized Anxiety Disorder 7-item scale (GAD-7) is commonly used by clinicians and researchers to screen for anxiety disorders and to monitor anxiety symptoms in primary care. However, findings regarding its factor structure are mixed, with most studies reporting a best-fitting for a one-factor structure, whereas others indicate a two-factor model. To be valid for comparisons, the GAD-7 should measure the same latent construct with the same structure across groups and over time. We aimed to examine the best-fit factor structure model of the GAD-7 among primary care patients and to evaluate its measurement invariance. Methods: A total of 1255 patients completed the computerized version of GAD-7 and a subsample of 238 cases was assessed at the 3-month follow-up. A confirmatory factor analysis (CFA) was performed and analyses of multiple-group invariance were also conducted to determine the extent to which the factor structure was comparable across various sociodemographic groups and over time. Results: The results showed that both a one-and two-factor structure (representing somatic and cognitive-affective components) were invariant across sociodemographic groups and over time. The two-factor structure provided the best model fit. Limitations: Results cannot be generalized to all primary care patients, as only patients whose general practitioners consider them to suffer emotional disorders were included. Conclusions: Our study supports the reliability and validity of the one-and two-factor model of the GAD-7, both for screening purposes and for monitoring response to treatment. prevalence of 20% in women and 9.9% in men (King et al., 2008). Furthermore, anxiety disorders are the most common reason for medical consultations among primary care patients (Combs and Markman, 2014; Kroenke et al., 2007; Ormel et al., 1994), mainly because the characteristics of the symptoms include psychological and somatic conditions that generate high levels of medical demand, representing up to 48% of such consultations (
International Journal of Clinical Trials, 2021
Background: Anxiety screening in primary care is crucial for the identification and management of the condition. The generalized anxiety disorder-2 (GAD-2) is an abridged version of the tool composed of the first two questions of the GAD-7 for screening for anxiety in the general adult population in primary care settings. Patients who score more than 3 points are further evaluated for anxiety. Although there is a growing body of literature documenting the psychometric properties of the GAD-2 against a structured interview and the GAD-7, no earlier studies have assessed the performance of the GAD-2 in Qatar. This cross-sectional study primarily aims to examine the sensitivity, specificity, positive (PPV) and negative predictive values (NPV) of GAD-2 scores for detecting anxiety among patients attending PHCC in Qatar.Methods: The study will employ a periodic cross-sectional study of electronic medical record data of adult patients attending the primary health care settings between Jan...
Psychiatry Research, 2011
Screening of Generalized Anxiety Disorder (GAD), which is often undetected and untreated, could be improved by quick and easy web-based data collection. This paper aims to validate the web-based self-rated 7-item GAD-7, its shortened 2-item GAD-2 and a single item from the GAD-7 scale (GAD-SI) to screen for GAD. Of a total of 502 subjects aged 18-80 who rated the web-based GAD-7, Center for Epidemiological Studies Depression scale (CES-D) and Hospital Anxiety and Depression Scale (HADS), 157 (31%) subjects had a WHO Composite International Diagnostic Interview for DSM-IV-disorders by telephone. The GAD-7 had good reliability. Subjects with a GADdiagnosis had significantly higher means on GAD-2, GAD-SI and GAD-7 than subjects without a GAD-diagnosis. The AUC (Area Under the Curve) of the GAD-SI and GAD-2 was accurate and not significantly different to the GAD-7 AUC. The web-based GAD-SI, GAD-2 and GAD-7 are reliable, valid tools to quickly screen for GAD in busy mental health settings and clinical research. More research is needed to validate the GAD-SI 'Do you have trouble relaxing' to see if its screening properties approach those of the GAD-7.
Using Generalized Anxiety Disorder-2 (GAD-2) and GAD-7 in a Primary Care Setting
2020
Anxiety disorders are highly prevalent in the primary care setting and are responsible for significant morbidity as well as a loss of productivity. Evaluation by mental health specialists and behavioral specialists can sometimes be confounded with problems of availability, accessibility, and the patient’s hesitancy to talk to new providers due to lack of prior relationship and trust. Primary care providers already have the advantage of being available for their patients, and have built years of trust behind them to strengthen this relationship. The biggest problems which confront primary care are the time constraints as well as the presence of multiple medical demands. This leads to a constant need for tools that facilitate early recognition and diagnosis of mental health disorders while also providing judicious utilization of clinic time. This article attempts to review the use of two of these popular tools: Generalized Anxiety Disorder scale-2 (GAD-2) and GAD-7 in the primary care...
Medical Care, 2008
The 7-item Generalized Anxiety Disorder Scale (GAD-7) is a practical self-report anxiety questionnaire that proved valid in primary care. However, the GAD-7 was not yet validated in the general population and thus far, normative data are not available. Objectives: To investigate reliability, construct validity, and factorial validity of the GAD-7 in the general population and to generate normative data. Research Design: Nationally representative face-to-face household survey conducted in Germany between May 5 and June 8, 2006. Subjects: Five thousand thirty subjects (53.6% female) with a mean age (SD) of 48.4 (18.0) years.
Journal of Anxiety Disorders, 2014
The fourth edition of the Generalized Anxiety Disorder Questionnaire (GAD-Q-IV) is a self-report measure that is commonly used to screen for the presence of generalized anxiety disorder (GAD). The current investigation attempted to identify an optimal cut score using samples obtained from an outpatient psychiatric (n = 163) and primary care clinic (n = 99). Results indicated that a cut score of 7.67 provided an optimal balance of sensitivity (.85) and specificity (.74) comparable to a previously identified cut score (5.7) across both samples (sensitivity = .90, specificity = .66). However, both cut scores were consistently outperformed by a score representing the criteria for GAD described in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (sensitivity = .89, specificity = .82).