Brief case finding tools for anxiety disorders: Validation of GAD-7 and GAD-2 in addictions treatment

Primary Care Mental Health Service, Leeds Community Healthcare NHS Trust, The Reginald Centre, 263 Chapeltown Road, Leeds LS7 3EX, United Kingdom.
Drug and alcohol dependence (Impact Factor: 3.42). 04/2012; 125(1-2):37-42. DOI: 10.1016/j.drugalcdep.2012.03.011
Source: PubMed

ABSTRACT Anxiety disorders are the most common mental health problems and often co-exist with substance use. Little evidence exists to support the use of brief screening tools for anxiety disorders in routine addictions treatment. This is the first study to test the validity and reliability of GAD-7 and GAD-2 in an outpatient drugs treatment population.
A sample of 103 patients completed brief screening questionnaires and took part in structured diagnostic assessments using CIS-R. A subgroup of 60 patients completed retests after 4 weeks. The results of brief questionnaires were compared to those of gold-standard diagnostic interviews using Receiver Operating Characteristic (ROC) curves. Psychometric properties were also calculated to evaluate the validity and reliability of self-completed questionnaires.
A GAD-7 score ≥ 9 had a sensitivity of 80% and specificity of 86% for any anxiety disorder, also displaying adequate temporal stability at repeated measurements (intra-class correlation=0.85) and high internal consistency (Cronbach's alpha=0.91). A GAD-2 score ≥ 2 had 94% sensitivity and 53% specificity, with adequate internal consistency (0.82).
GAD-7 adequately detected the presence of an anxiety disorder in drug and alcohol users; although this study was limited by sample size to determine its reliability for specific diagnoses. Results in this small sample suggest that GAD-7 may be a useful screening tool in addiction services, although replication in a larger sample is warranted.

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Available from: Jaime Delgadillo, Jan 31, 2015
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    • "This nine-item questionnaire renders a severity score between 0 and 27, and has been validated as a reliable case-finding tool for clinically significant depression symptoms in substance users based on a cut-off score ≥12 (Delgadillo et al., 2011). The GAD-7 questionnaire (Spitzer, et al., 2006) was used to assess severity of comorbid anxiety symptoms, with scores ranging between 0 and 21, where a score ≥9 indicates clinically significant anxiety (Delgadillo et al., 2012). In order to assess severity of substance dependence, participants completed the SDS measure (SDS; Gossop et al., 1995). "
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    • "This first case-finding step could then be supplemented by more robust and validated self-completed screening tools for depression (Hides et al., 2007; Lykke, Hesse, Austin, & Oestrich, 2008; Delgadillo et al., 2011; McPherson & Martin, 2011) or anxiety disorders (McPherson & Martin, 2011; Delgadillo et al., 2012 a). The acceptability of using such self-completed screening tools in routine practice has been demonstrated in qualitative research with patients in drugs treatment (Delgadillo et al., 2012 b). The third step in this method might involve the use of structured diagnostic interviews or formal psychiatric evaluation in cases where multiple diagnoses or high severity are suspected. "
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