Diagnosing GAD, Panic Disorder: Which Screening Methods Work Best?
the MPR take:
Two screening instruments for generalized anxiety disorder (GAD) and panic disorder could be feasible for use in primary care to identify these common but underdiagnosed conditions. A systematic review of research in the Journal of the American Medical Association evaluated the diagnostic accuracy of self-report screening instruments for GAD or panic disorder vs. a trained clinical diagnosis made using Diagnostic and Statistical Manual of Mental Disorders or International Classification of Diseases criteria. Nine screening instruments were identified, with the Generalized Anxiety Disorder Scale 7 Item (GAD-7) as the best-performing test with a positive likelihood ratio of 5.1 (95% CI, 4.3–6.0) and a negative likelihood ratio of 0.13 (95% CI, 0.07–0.25). The Patient Health Questionnaire was the best-performing screening instrument for panic disorder, with a positive likelihood ratio of 78 (95% CI, 29–210) and a negative likelihood ratio of 0.20 (95% CI, 0.11–0.37). The authors warn that these instruments need further validation in clinical research on multiple primary care populations.
Importance: In primary care settings, generalized anxiety disorder (GAD) and panic disorder are common but underrecognized illnesses. Identifying accurate and feasible screening instruments for GAD and panic disorder has the potential to improve detection and facilitate treatment. Data Sources: We searched MEDLINE, PsycINFO, and the Cochrane Library for relevant articles published from 1980 through April 2014.
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