Musculoskeletal care · 2025
Diagnostic and Clinical Utility of the Generalised Anxiety Disorder-2 (GAD-2) for Screening Anxiety Symptoms in Individuals With Persistent Musculoskeletal Pain Attending Physiotherapy.
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Vancampfort Davy, McGrath Ryan L, Dankaerts Wim, Van Assche Dieter, Lambrechts Monica, Stubbs Brendon, Van Damme Tine
Аннотация
INTRODUCTION: This cross-sectional study assesses the diagnostic and clinical utility of the 2-item Generalised Anxiety Disorder Scale (GAD-2) for screening anxiety symptoms in individuals with persistent musculoskeletal pain attending physiotherapy.
METHODS: In total, 450 patients (mean age = 53.3 ± 12.2 years; 109 male; mean illness duration = 0.5 ± 8.8 years) with persistent musculoskeletal pain were recruited in 84 private physiotherapy practices. Patients completed the Generalised Anxiety Disorder-7 (GAD-7) and GAD-2. Internal consistency was calculated for both measures. Area under the receiver operating characteristics curve (AUC) and Youden's J were calculated to determine the optimal GAD-2 cutoff score for identifying clinically significant anxiety symptoms, as defined by the previously validated GAD-7 cutoff score of ≥ 11 for persistent pain patients.
RESULTS: Internal consistency was good for the GAD-7 (Cronbach α = 0.89) and acceptable for the GAD-2 (α = 0.71). Both measures were moderately correlated (r = 0.39, p < 0.001). GAD-2 had moderate overall accuracy for identifying clinically significant anxiety (AUC = 0.70; 95% confidence interval, 0.66-0.74). A GAD-2 cutoff score of ≥ 3 provided the most optimal balance of sensitivity (59%) and specificity (75%). Alternatively, a cutoff score of ≥ 2 provided a better sensitivity (70%) but worse specificity (56%).
DISCUSSION: The GAD-2 is a clinically useful and psychometrically acceptable tool for screening anxiety symptoms in patients with persistent pain attending physiotherapy.
CONCLUSION: The GAD-2 has the potential to identify patients with persistent pain who are at risk of anxiety disorders and who may benefit from additional mental health support.
METHODS: In total, 450 patients (mean age = 53.3 ± 12.2 years; 109 male; mean illness duration = 0.5 ± 8.8 years) with persistent musculoskeletal pain were recruited in 84 private physiotherapy practices. Patients completed the Generalised Anxiety Disorder-7 (GAD-7) and GAD-2. Internal consistency was calculated for both measures. Area under the receiver operating characteristics curve (AUC) and Youden's J were calculated to determine the optimal GAD-2 cutoff score for identifying clinically significant anxiety symptoms, as defined by the previously validated GAD-7 cutoff score of ≥ 11 for persistent pain patients.
RESULTS: Internal consistency was good for the GAD-7 (Cronbach α = 0.89) and acceptable for the GAD-2 (α = 0.71). Both measures were moderately correlated (r = 0.39, p < 0.001). GAD-2 had moderate overall accuracy for identifying clinically significant anxiety (AUC = 0.70; 95% confidence interval, 0.66-0.74). A GAD-2 cutoff score of ≥ 3 provided the most optimal balance of sensitivity (59%) and specificity (75%). Alternatively, a cutoff score of ≥ 2 provided a better sensitivity (70%) but worse specificity (56%).
DISCUSSION: The GAD-2 is a clinically useful and psychometrically acceptable tool for screening anxiety symptoms in patients with persistent pain attending physiotherapy.
CONCLUSION: The GAD-2 has the potential to identify patients with persistent pain who are at risk of anxiety disorders and who may benefit from additional mental health support.