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Gen Hosp Psychiatry. 2016 Mar-Apr;39:24-31. doi: 10.1016/j.genhosppsych.2015.11.005. Epub 2015 Nov 18.

Screening for anxiety disorders with the GAD-7 and GAD-2: a systematic review and diagnostic metaanalysis.

Author information

1
Department of Health Sciences, University of York, York YO10 5DD, United Kingdom.
2
Hull York Medical School and Department of Health Sciences, University of York, York YO10 5DD United Kingdom.
3
Hull York Medical School and Department of Health Sciences, University of York, York YO10 5DD United Kingdom. Electronic address: dean.mcmillan@york.ac.uk.

Abstract

OBJECTIVE:

To systematically review the accuracy of the GAD-7 and GAD-2 questionnaires for identifying anxiety disorders.

METHODS:

A systematic review of the literature was conducted to identify studies that validated the GAD-7 or GAD-2 against a recognized gold standard diagnosis. Pooled estimates of diagnostic test accuracy were produced using random-effects bivariate metaanalysis. Heterogeneity was explored using the I(2) statistic.

RESULTS:

A total of 12 samples were identified involving 5223 participants; 11 samples provided data on the accuracy of the GAD-7 for identifying generalized anxiety disorder (GAD). Pooled sensitivity and specificity values appeared acceptable at a cutoff point of 8 [sensitivity: 0.83 (95% CI 0.71-0.91), specificity: 0.84 (95% CI 0.70-0.92)] although cutoff scores 7-10 also had similar pooled estimates of sensitivity/specificity. Six samples provided data on the accuracy of the GAD-2 for identifying GAD. Pooled sensitivity and specificity values appeared acceptable at a cutoff of 3 [sensitivity: 0.76 (95% CI 0.55-0.89), specificity: 0.81 (95% CI 0.60-0.92)]. Four studies looked at the accuracy of the questionnaires for identifying any anxiety disorder.

CONCLUSIONS:

The GAD-7 had acceptable properties for identifying GAD at cutoff scores 7-10. The GAD-2 had acceptable properties for identifying GAD at a cutoff score of 3. Further validation studies are needed.

KEYWORDS:

Anxiety; Diagnostic test accuracy; Generalised anxiety disorder; Sensitivity and specificity; Systematic review

[Indexed for MEDLINE]

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