Diagnostic and Clinical Utility of the GAD-2 for Screening Anxiety Symptoms in Individuals With Multiple Sclerosis.
Abbey J Hughes, Katherine M Dunn, Trisha Chaffee and 2 others
PMID 29964000WHAT IT FOUND
For adults with multiple sclerosis, a two-question anxiety screen at a score of 3 or more correctly flagged 87% of positive cases and 92% of negative cases on the seven-question anxiety screen.
Key findings
01In the 99 analysed participants, a GAD-2 score of 3 or more correctly identified 87% of those who screened positive on the GAD-7 and 92% of those who screened negative.
02The two-question GAD-2 score closely matched the seven-question GAD-7 anxiety score in this sample.
03Using the GAD-7 score of 8 or more as the reference, 23% of participants screened positive for clinically significant anxiety.
STILL TO COME
How it was doneWhat they found
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What it does not show
The study used a cross-sectional questionnaire design, so it cannot show that anxiety predicts future physical function or participation. The GAD-2 was checked against the GAD-7 self-report score, not against a clinical diagnostic interview for anxiety disorder. Only 23% of participants had clinically significant anxiety on the GAD-7, lower than prior prevalence studies, so the sample may not represent the broader MS population. Disability severity was not collected, so the authors could not check whether participants' disability levels were comparable to other MS samples. Because the primary study involved cognitive testing, people with higher anxiety may have been less likely to participate.
Declared interests
No funding or conflict-of-interest statement is provided in the supplied text; the publication types list NIH and non-U.S. government research support.
The easy way to misread this
Do not treat a GAD-2 score of 3 or more as a confirmed anxiety disorder. The study compared the GAD-2 with the GAD-7 questionnaire, not a clinical diagnostic interview. The paper also reports that a lower score of 2 or more carries a 24% false-positive risk.