Ruth Ann Marrie1, Lixia Zhang2, Lisa M Lix2, Lesley A Graff3, John R Walker3, John D Fisk4, Scott B Patten5, Carol A Hitchon6, James M Bolton7, Jitender Sareen7, Renée El-Gabalawy8, James J Marriott6, Charles N Bernstein6. 1. Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada. Electronic address: rmarrie@hsc.mb.ca. 2. Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada. 3. Department of Clinical Health Psychology, Max Rady College of Medicine Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada. 4. Nova Scotia Health Authority, Departments of Psychiatry, Psychology & Neuroscience, and Medicine, Dalhousie University, Halifax, Canada. 5. Departments of Community Health Sciences & Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada. 6. Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada. 7. Department of Psychiatry, Max Rady College of Medicine Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada. 8. Department of Clinical Health Psychology, Max Rady College of Medicine Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Departments of Anesthesia & Perioperative Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
Abstract
OBJECTIVE: We aimed to evaluate the validity and reliability of multiple screening measures for depression and anxiety for use in the clinical care of people with multiple sclerosis (MS). METHODS: Participants with MS completed the Patient Health Questionnaire (PHQ-9), Hospital Anxiety and Depression Scale (HADS), Kessler-6 Distress Scale, PROMIS Emotional Distress Depression Short-Form 8a (PROMIS Depression) and Anxiety Short-Form 8a (PROMIS Anxiety), Generalized Anxiety Disorder 7-item Scale (GAD-7), and the Overall Anxiety and Severity Impairment Scale (OASIS). A subgroup repeated the screening measures two weeks later. All participants also completed a Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID). For the screening measures we computed sensitivity, specificity, positive predictive and negative predictive value with SCID diagnoses as the reference standard and conducted receiver operating curve (ROC) analyses; we also assessed internal consistency and test-retest reliability. RESULTS: Of 253 participants, the SCID classified 10.3% with major depression and 14.6% with generalized anxiety disorder. Among the depression measures, the PHQ-9 had the highest sensitivity (84%). Specificity was generally higher than sensitivity, and was highest for the HADS-D with a cut-point of 11 (95%). In ROC analyses the area under the curve (AUC) did not differ between depression measures. Among the anxiety measures, sensitivity was highest for the HADS-A with a cut-point of 8 (82%). Specificity ranged from 83% to 86% for all measures except the HADS-A with a cut-point of 8 (68%). The AUC did not differ between anxiety measures. CONCLUSION: Overall, performance of the depression and anxiety screening measures was very similar, with reasonable psychometric properties for the MS population, suggesting that other factors such as accessibility and ease of use could guide the choice of measure in clinical practice.
OBJECTIVE: We aimed to evaluate the validity and reliability of multiple screening measures for depression and anxiety for use in the clinical care of people with multiple sclerosis (MS). METHODS:Participants with MS completed the Patient Health Questionnaire (PHQ-9), Hospital Anxiety and Depression Scale (HADS), Kessler-6 Distress Scale, PROMIS Emotional Distress Depression Short-Form 8a (PROMIS Depression) and Anxiety Short-Form 8a (PROMIS Anxiety), Generalized Anxiety Disorder 7-item Scale (GAD-7), and the Overall Anxiety and Severity Impairment Scale (OASIS). A subgroup repeated the screening measures two weeks later. All participants also completed a Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID). For the screening measures we computed sensitivity, specificity, positive predictive and negative predictive value with SCID diagnoses as the reference standard and conducted receiver operating curve (ROC) analyses; we also assessed internal consistency and test-retest reliability. RESULTS: Of 253 participants, the SCID classified 10.3% with major depression and 14.6% with generalized anxiety disorder. Among the depression measures, the PHQ-9 had the highest sensitivity (84%). Specificity was generally higher than sensitivity, and was highest for the HADS-D with a cut-point of 11 (95%). In ROC analyses the area under the curve (AUC) did not differ between depression measures. Among the anxiety measures, sensitivity was highest for the HADS-A with a cut-point of 8 (82%). Specificity ranged from 83% to 86% for all measures except the HADS-A with a cut-point of 8 (68%). The AUC did not differ between anxiety measures. CONCLUSION: Overall, performance of the depression and anxiety screening measures was very similar, with reasonable psychometric properties for the MS population, suggesting that other factors such as accessibility and ease of use could guide the choice of measure in clinical practice.
Authors: Katie L J Cederberg; Brenda Jeng; Jeffer E Sasaki; E Morghen Sikes; Stephanie L Silveira; Gary Cutter; Robert W Motl Journal: Mult Scler Relat Disord Date: 2021-08-08 Impact factor: 4.808
Authors: Lindsay O Neto; Elizabeth S Gromisch; Jessica Sloan; Tuula Tyry; Frederick W Foley Journal: Qual Life Res Date: 2018-10-17 Impact factor: 4.147
Authors: Stephanie L Silveira; Katie L J Cederberg; Brenda Jeng; E Morghen Sikes; Brian M Sandroff; Catherine D Jones; Robert W Motl Journal: Qual Life Res Date: 2020-11-05 Impact factor: 4.147
Authors: Ruth Ann Marrie; Ronak Patel; Charles N Bernstein; James M Bolton; Lesley A Graff; James J Marriott; Carol A Hitchon; Chase R Figley; Jennifer Kornelsen; John D Fisk Journal: Mult Scler Date: 2020-09-25 Impact factor: 6.312
Authors: Victoria A Grunberg; Ryan A Mace; Sarah M Bannon; Jonathan Greenberg; Jafar Bakhshaie; Ana-Maria Vranceanu Journal: J Affect Disord Date: 2021-06-05 Impact factor: 6.533