An updated systematic review and meta-analysis of the predictive validity of the general anxiety disorder (GAD)-7 and GAD-2 in screening for anxiety disorders.

BACKGROUND

This study was an updated systematic review and meta-analysis to examine the validity of the general anxiety disorder (GAD)-7 and GAD-2 for GAD and other anxiety disorders.

METHODS

Electronic searches were performed using MEDLINE, EMBASE, CINAHL, and PsycArticles databases. This review compared the predictive validity of the GAD-7, GAD-2, and other anxiety screening tools and conducted a subgroup analysis based on the GAD-7 according to the target anxiety and participant characteristics.

RESULTS

In total, 45 studies were selected based on the inclusion criteria. The sensitivity of GAD-7 (43 studies) was 0.81 (95 % CI, 0.78-0.84), specificity was 0.78 (95 % CI, 0.74-0.81), and sROC AUC was 0.87. For GAD-2 (13 studies), the sensitivity was 0.78 (95 % CI, 0.73-0.83), specificity was 0.81 (95 % CI, 0.73-0.86), and sROC AUC was 0.86. For other anxiety screening tools (seven studies) the sensitivity was 0.78 (95 % CI, 0.74-0.82), specificity was 0.81 (95 % CI, 0.74-0.86), sROC AUC was 0.86. In the subgroup analysis according to anxiety targets, when measuring GAD alone, the sensitivity and specificity of GAD-7 were higher than those of other anxiety disorders, with an sROC AUC of 0.88 versus 0.84. In the subgroup analysis of the participants, the sensitivity in patients with epilepsy was 0.89, which was higher than that in other participants.

CONCLUSIONS

This study demonstrated that the GAD-7 had adequate diagnostic accuracy, suggesting that it can help screen patients with anxiety disorders. Moreover, the GAD-7 has a high screening validity for anxiety in patients with epilepsy.