Sensitivity to change and minimal clinically important difference of the 7-item Generalized Anxiety Disorder Questionnaire (GAD-7)
Sensitivity to change and minimal clinically important difference of the 7-item Generalized Anxiety Disorder Questionnaire (GAD-7)
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DOI：
10.1016/j.jad.2020.01.032
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发表时间：
2020-03-15
影响因子：
6.6
通讯作者：
Loewe, Bernd
中科院分区：
文献类型：
--
作者：
Toussaint, Anne;Huesing, Paul;Loewe, Bernd
背景：有效的治疗需要定期随访和监测症状。我们调查了广泛性焦虑障碍量表（GAD 7）的变化和最小的临床重要差异的敏感性。方法：本研究包括所有参与者的慢性抑郁症的多地点试验。基线和随访（12周和48周）数据用于评估治疗反应。根据汉密尔顿抑郁评定量表（HRSD-24）评分，计算GAD-7前后平均变化的效应量（ES）和标准化反应均值（SRM）。在根据HRSD-24改善的患者亚组中，12周后GAD-7评分显著降低（t =-6.31，df = 120，p < .001; ES =-0.51，SRM =-0.57），治疗48周（t =-12.68，df = 141，p < .001; ES =-1.0，SRM = -1.7）。在恶化组中，与基线相比，12周后GAD-7评分显著升高（t = 2.96，df = 41，p = 0.005; ES = 0.30，SRM = 0.46），48周后增加（t = 1.99，df = 21，p = 0.059; ES = 0.37，SRM = 0.43）。未改变组的基线和随访之间没有显着差异。MCID估计4点上的GAD-7总score.Limitations：确认这些发现和进一步调查的GAD-7在人群和试验集中在焦虑特异性treatment is highly recommended.Conclusions：结果表明，GAD-7是敏感的检测在治疗过程中的精神病理学变化。
Background: Effective treatment requires regular follow-up and monitoring of symptoms. We investigated sensitivity to change and minimal clinically important difference of the Generalized Anxiety Disorder Scale (GAD7).Methods: This study included all participants from a multisite trial of chronic depression. Baseline and follow-up (12 and 48 weeks) data were used to assess treatment response. Effect sizes (ES) and standardized response means (SRM) of pre- and post-GAD-7 mean changes were calculated for subgroups of patients, who did or did not improve according to ratings in the Hamilton Rating Scale for Depression (HRSD-24).Results: N = 261 patients were included in the analyses. In the subgroup of patients who improved according to HRSD-24, GAD-7 scores were significantly lower after 12 weeks (t = - 6.31, df = 120, p < .001; ES = - 0.51, SRM = - 0.57), and 48 weeks of treatment (t = - 12.68, df = 141, p < .001; ES = -1.0, SRM = -1.7), when compared to admission. In the group who worsened, GAD-7 scores were significantly higher after 12 weeks (t = 2.96, df = 41, p = .005; ES = 0.30, SRM = 0.46), and increased after 48 weeks (t = 1.99, df = 21, p = .059; ES = 0.37, SRM = 0.43), when compared to baseline. The unchanged group showed no significant difference between baseline and follow-up. MCID was estimated 4 points on the GAD-7 total score.Limitations: Confirmation of these findings and further investigation of the GAD-7 in populations and trials focusing on anxiety-specific treatment is highly recommended.Conclusions: Results show that the GAD-7 is sensitive to detect change in psychopathology over the course of treatment.