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J Affect Disord. 2013 Sep 25;150(3):1008-18. doi: 10.1016/j.jad.2013.05.031. Epub 2013 Jun 28.

Reference values for anxiety questionnaires: the Leiden Routine Outcome Monitoring Study.

Author information

1
Department of Psychiatry, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands. Y.W.M.Schulte-van_Maaren@lumc.nl

Abstract

BACKGROUND:

The monitoring of patients with an anxiety disorder can benefit from Routine Outcome Monitoring (ROM). As anxiety disorders differ in phenomenology, several anxiety questionnaires are included in ROM: Brief Scale for Anxiety (BSA), PADUA Inventory Revised (PI-R), Panic Appraisal Inventory (PAI), Penn State Worry Questionnaire (PSWQ), Worry Domains Questionnaire (WDQ), Social Interaction, Anxiety Scale (SIAS), Social Phobia Scale (SPS), and the Impact of Event Scale-Revised (IES-R). We aimed to generate reference values for both 'healthy' and 'clinically anxious' populations for these anxiety questionnaires.

METHODS:

We included 1295 subjects from the general population (ROM reference-group) and 5066 psychiatric outpatients diagnosed with a specific anxiety disorder (ROM patient-group). The MINI was used as diagnostic device in both the ROM reference group and the ROM patient group. To define limits for one-sided reference intervals (95th percentile; P95) the outermost 5% of observations were used. Receiver Operating Characteristics (ROC) analyses were used to yield alternative cut-off values for the anxiety questionnaires.

RESULTS:

For the ROM reference-group the mean age was 40.3 years (SD=12.6), and for the ROM patient-group it was 36.5 years (SD=11.9). Females constituted 62.8% of the reference-group and 64.4% of the patient-group. P95 ROM reference group cut-off values for reference versus clinically anxious populations were 11 for the BSA, 43 for the PI-R, 37 for the PAI Anticipated Panic, 47 for the PAI Perceived Consequences, 65 for the PAI Perceived Self-efficacy, 66 for the PSWQ, 74 for the WDQ, 32 for the SIAS, 19 for the SPS, and 36 for IES-R. ROC analyses yielded slightly lower reference values. The discriminative power of all eight anxiety questionnaires was very high.

LIMITATIONS:

Substantial non-response and limited generalizability.

CONCLUSIONS:

For eight anxiety questionnaires a comprehensive set of reference values was provided. Reference values were generally higher in women than in men, implying the use of gender-specific cut-off values. Each instrument can be offered to every patient with MAS disorders to make responsible decisions about continuing, changing or terminating therapy.

KEYWORDS:

Anxiety; Anxiety disorders; Instruments; Questionnaires; Reference values; Routine Outcome Monitoring

PMID:
23810480
DOI:
10.1016/j.jad.2013.05.031
[Indexed for MEDLINE]

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