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


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.

Download full-text


Available from: Jaime Delgadillo, Jan 31, 2015
  • Source
    • "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). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Purpose – To explore addiction service users' experiences of psychological interventions for depression symptoms, with an emphasis on understanding obstacles to engage with treatment. Design – This was a thematic analysis of semi-structured interviews with 10 people who took part in a randomised controlled trial of cognitive and behavioural interventions; 4 of whom never engaged with treatment. Findings – Five prominent obstacles to access therapy were: memory deficits, becoming overwhelmed by multiple demands and appointments, being housebound due to fluctuations in mental health problems, tendency to avoid the unfamiliar, and contextual life problems related to deprivation and social conflict. Research limitations/implications – We note some possible limitations related to overreliance on telephone interviews and interviewers' field-notes. We discuss our findings in light of epidemiological research, cognitive, behavioural and motivational enhancement theories. Practical implications – We propose it is important to recognise and address multiple obstacles to therapy. Offering therapy appointments that are co-located within addiction services and time-contingent to other social/medical interventions may help to address some of these obstacles. Originality/value – The present qualitative results complement our prior experimental research and enrich our understanding of how to maximise engagement with psychological interventions.
    Full-text · Article · Jul 2015
  • Source
    • "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. "
    [Show abstract] [Hide abstract]
    ABSTRACT: This study aimed to determine the validity and reliability of the Treatment Outcomes Profile (TOP) psychological health scale (item 4a) as a case finding tool for common mental disorders. This cross-sectional diagnostic validation study involving 103 outpatients in a mainstream community drugs treatment service in Leeds, United Kingdom. Psychiatric diagnosis of a common mental disorder (CMD) was established using a structured gold-standard interview (CIS-R) based on ICD-10 criteria. Participants also completed the TOP measure and severity of dependence scale (SDS). A TOP item 4a score ≤12 had a sensitivity of 83% and specificity of 71% for a diagnosable common mental disorder, with moderate agreement between baseline and re-test measures (intra-class correlation = 0.78). The TOP scale was negatively correlated with overall CIS-R severity scores (r = -.60, p < .001), but was not correlated with SDS. Reliable and clinically significant improvement was defined based on a score >12 and a reliable change index ≥ 6. Psychometric testing in this moderate sample suggests that the TOP psychological health scale is a valid ultra-brief case finding measure for common mental disorders in drug and alcohol users. It might be usefully integrated as the starting point in a stepwise assessment method.
    Full-text · Article · May 2013 · Mental Health and Substance Use dual diagnosis
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This manuscript reviews how patient-reported outcomes data can be used to guide efforts to improve patient outcomes. Review Manuscript. The clinical management of chronic, non-cancer pain. Adult patients receiving treatment for chronic, non-cancer pain. While there have been great advances in the science of pain and various therapeutic medications and interventions, patient outcomes are variable. This manuscript reviews how outcomes data can be used to guide efforts to improve patient outcomes. Patient outcomes can be improved with standardization of the process of patient care, as well as through other quality improvement efforts. The cornerstone to any effort to improve patient outcomes starts with the integration of valid outcomes data collection into ongoing patient care. Outcome measurement tools should provide information on several key domains, yet the process of data collection should not pose a significant burden on either the patient or health care team. Efforts to improve patient outcomes are ongoing, and should be a high priority for every health care team.
    Full-text · Article · Apr 2013 · Pain Medicine
Show more

We use cookies to give you the best possible experience on ResearchGate. Read our cookies policy to learn more.