An international risk prediction algorithm for the onset of generalized anxiety and panic syndromes in general practice attendees: predictA
An international risk prediction algorithm for the onset of generalized anxiety and panic syndromes in general practice attendees: predictA
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DOI：
10.1017/s0033291710002400
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发表时间：
2011-08-01
影响因子：
6.9
通讯作者：
Nazareth, I.
中科院分区：
文献类型：
--
作者：
King, M.;Bottomley, C.;Nazareth, I.
背景。目前还没有预测焦虑的风险模型可以帮助预防。我们的目的是为广泛性焦虑和恐慌综合征的发作制定一个风险算法。在2003年4月至2005年2月期间招募了家庭实践参与者，并在英国，西班牙，葡萄牙和斯洛文尼亚（欧洲4个国家）进行了超过24个月的随访，在荷兰，爱沙尼亚和智利进行了超过6个月的随访。我们的主要结局是广泛性焦虑和恐慌综合征，由患者健康问卷测量。我们在欧洲数据中使用逐步逻辑回归将38个变量输入风险模型中，修正了过度拟合，并在荷兰、爱沙尼亚和智利进行了测试。欧洲有4905人参加，爱沙尼亚有1094人，荷兰有1221人，智利有2825人。算法中四个变量为固定特征（性别、年龄、终生抑郁筛查、心理困难家族史）；三项现状（短表12身体健康量表和精神健康量表得分，以及有偿和/或无偿工作中得不到支持的困难）；一个有关国家；还有一次跟进。欧洲的总体c -指数为0.752[95%可信区间（CI） 0.724-0.780]。发生焦虑与未发生焦虑的预测对数比值差异的效应量为0.972 （95% CI 0.837-1.107）。通过对predictA的验证，爱沙尼亚的c -指数为0.731 (95% CI 0.654-0.809)，荷兰为0.811 (95% CI 0.736-0.886)，智利为0.707 （95% CI 0.671-0.742）。PredictA能准确预测焦虑综合症的风险。该算法与重度抑郁症的预测算法惊人地相似，这表明焦虑和抑郁的概念有相当大的重叠。
Background. There are no risk models for the prediction of anxiety that may help in prevention. We aimed to develop a risk algorithm for the onset of generalized anxiety and panic syndromes.Method. Family practice attendees were recruited between April 2003 and February 2005 and followed over 24 months in the UK, Spain, Portugal and Slovenia (Europe4 countries) and over 6 months in The Netherlands, Estonia and Chile. Our main outcome was generalized anxiety and panic syndromes as measured by the Patient Health Questionnaire. We entered 38 variables into a risk model using stepwise logistic regression in Europe4 data, corrected for over-fitting and tested it in The Netherlands, Estonia and Chile.Results. There were 4905 attendees in Europe4, 1094 in Estonia, 1221 in The Netherlands and 2825 in Chile. In the algorithm four variables were fixed characteristics (sex, age, lifetime depression screen, family history of psychological difficulties); three current status (Short Form 12 physical health subscale and mental health subscale scores, and unsupported difficulties in paid and/or unpaid work); one concerned country; and one time of follow-up. The overall C-index in Europe4 was 0.752 [95% confidence interval (CI) 0.724-0.780]. The effect size for difference in predicted log odds between developing and not developing anxiety was 0.972 (95% CI 0.837-1.107). The validation of predictA resulted in C-indices of 0.731 (95% CI 0.654-0.809) in Estonia, 0.811 (95% CI 0.736-0.886) in The Netherlands and 0.707 (95% CI 0.671-0.742) in Chile.Conclusions. PredictA accurately predicts the risk of anxiety syndromes. The algorithm is strikingly similar to the predictD algorithm for major depression, suggesting considerable overlap in the concepts of anxiety and depression.