Diagnostic and Clinical Utility of the GAD-2 for Screening Anxiety Symptoms in Individuals With Multiple Sclerosis
Diagnostic and Clinical Utility of the GAD-2 for Screening Anxiety Symptoms in Individuals With Multiple Sclerosis
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DOI：
10.1016/j.apmr.2018.05.029
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发表时间：
2018-10-01
影响因子：
4.3
通讯作者：
Beier, Meghan
中科院分区：
文献类型：
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作者：
Hughes, Abbey J.;Dunn, Katherine M.;Beier, Meghan
目的：评价广泛性焦虑障碍量表(GAD-2)在多发性硬化(MS)患者焦虑症状筛查中的诊断和临床应用价值。设计：横断面研究。地点：大学附属MS神经科和康复中心。研究对象：在大学附属MS中心接受治疗的99名成年人(N=99)(年龄19-72岁；平均+/-SD=46.2+/-13.0；75%女性)。病程从1年到37年(平均+/-SD=10.7+/-8.4)。干预措施：不适用。主要观察指标：参与者完成了由7个条目组成的广泛性焦虑障碍量表(GAD-7)和GAD-2。计算两种测量的内部一致性。计算受试者工作特征曲线下面积(AUC)、AUC的95%可信区间和Youden‘s J，以确定识别临床显著焦虑症状的最佳GAD-2截断值，如先前验证的GAD-7截断值>；=8所定义。结果：GAD-7的内部一致性极好(Cronbachα=.91)，GAD-2的内部一致性可接受(α=.77)，测量结果高度相关(r=.94)。GAD-2在识别临床显著焦虑症状方面具有极好的总体准确性(AUC=0.97；95%可信区间0.94-1.00)。GAD-2评分为>；=3为检测临床显著焦虑症状提供了良好的灵敏度(0.87)和良好的特异度(0.92)之间的最佳平衡。另外，<gt；=2的临界值提供了良好的灵敏度(1.00)和中等的特异度(0.76)。结论：GAD-2是一种在MS康复和神经科护理环境中筛选焦虑症状的临床有用和心理测量学有效的工具。重要的是，这一工具有可能识别有焦虑障碍风险的多发性硬化症患者，以及可能从康复心理干预中受益的人，以最终改善功能和生活质量。(C)2018年美国康复医学大会
Objective: To assess the diagnostic and clinical utility of the 2-item Generalized Anxiety Disorder Scale (GAD-2) for screening anxiety symptoms in individuals with multiple sclerosis (MS).Design: Cross-sectional.Setting: University-affiliated MS neurology and rehabilitation center.Participants: The sample comprised adults (N=99) (ages 19-72; mean +/- SD=46.2 +/- 13.0; 75% women) with a physician-confirmed MS diagnosis who were receiving care in a university-affiliated MS center. Disease durations ranged from 1 to 37 years (mean +/- SD = 10.7 +/- 8.4).Interventions: Not applicable.Main Outcome Measures: Participants completed the 7-item Generalized Anxiety Disorder Scale (GAD-7) and GAD-2. Internal consistency was calculated for both measures. Area under the receiver operating characteristics curve (AUC), the 95% confidence interval for the AUC, and Youden's J were calculated to determine the optimal GAD-2 cutoff score for identifying clinically significant anxiety symptoms, as defined by the previously validated GAD-7 cutoff score of >= 8.Results: Internal consistency was excellent for the GAD-7 (Cronbach alpha = .91) and acceptable for the GAD-2 (alpha = .77), and the measures were highly correlated (r=.94). The GAD-2 had excellent overall accuracy for identifying clinically significant anxiety symptoms (AUC = 0.97; 95% confidence interval, 0.94-1.00). A GAD-2 cutoff score of >= 3 provided an optimal balance of good sensitivity (0.87) and excellent specificity (0.92) for detecting clinically significant anxiety symptoms. Alternatively, a cutoff score of >= 2 provided excellent sensitivity (1.00) and fair specificity (0.76).Conclusions: The GAD-2 is a clinically useful and psychometrically valid tool for screening anxiety symptoms in MS rehabilitation and neurology care settings. Importantly, this tool has the potential to identify individuals with MS who are at risk for anxiety disorders and who may benefit from rehabilitation psychology interventions to ultimately improve functioning and quality of life. (C) 2018 by the American Congress of Rehabilitation Medicine