Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/19508
Title: Prevalence and identification of anxiety disorders in pregnancy: the diagnostic accuracy of the two-item Generalised Anxiety Disorder scale (GAD-2).
Austin Authors: Nath, Selina;Ryan, Elizabeth G;Trevillion, Kylee;Bick, Debra;Demilew, Jill;Milgrom, Jeannette ;Pickles, Andrew;Howard, Louise M
Affiliation: Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
Parent-Infant Research Institute, Austin Health, Heidelberg, Victoria, Australia
South London and Maudsley NHS Foundation Trust, London, UK
Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
Women's Health, King's College Hospital NHS Foundation Trust, London, UK
Section of Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
Biostatistics and Health Informatics Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
Issue Date: 5-Sep-2018
Date: 2018-09-05
Publication information: BMJ Open 2018; 8(9): e023766
Abstract: To estimate the population prevalence of anxiety disorders during pregnancy and investigate the diagnostic accuracy of the two-item Generalised Anxiety Disorder scale (GAD-2) for a) GAD and b) any anxiety disorder. Cross-sectional survey using a stratified sampling design. Sampling weights were used in the analysis to adjust for the bias introduced by the stratified sampling. Inner-city maternity service, South London. 545 pregnant women were interviewed after their first antenatal appointment; 528 provided answers on the GAD-2 questions. Diagnosis generated by the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th edition (SCID). Population prevalence of anxiety disorders was 17% (95% CI 12% to 21%): 5% (95% CI 3% to 6%) for GAD, 4% (95% CI 2% to 6%) for social phobia, 8% (95% CI 5% to 11%) for specific phobia and 2% (95% CI 1% to 4%) for obsessive-compulsive disorder. Post-traumatic stress disorder (PTSD) prevalence was unclear due to higher levels of reluctance to respond to PTSD interview questions but sensitivity analyses suggest population prevalence maybe up to 4% (95% CI 2% to 6%). Weighted sensitivity of GAD-2 for GAD (cut-off ≥3) was 69%, specificity 91%, positive predictive value 26%, negative predictive value 98% and likelihood ratio 7.35. For any anxiety disorder the weighted sensitivity was 26%, specificity 91%, positive predictive value 36%, negative predictive value 87% and likelihood ratio 2.92. Anxiety disorders are common but GAD-2 generates many false positives and may therefore be unhelpful in maternity services.
URI: https://ahro.austin.org.au/austinjspui/handle/1/19508
DOI: 10.1136/bmjopen-2018-023766
ORCID: 0000-0002-5976-1301
0000-0002-4082-4595
Journal: BMJ Open
PubMed URL: 30185582
Type: Journal Article
Subjects: anxiety disorders
diagnostic accuracy
gad
gad-2
maternal
Appears in Collections:Journal articles

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