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Prevalence and identification of anxiety disorders in pregnancy : the diagnostic accuracy of the two-item Generalised Anxiety Disorder scale (GAD-2)
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Nath, Selina, Ryan, Elizabeth G., Trevillion, Kylee, Bick, Debra, Demilew, Jill, Milgrom, Jeannette, Pickles, Andrew and Howard, Louise M. (2018) Prevalence and identification of anxiety disorders in pregnancy : the diagnostic accuracy of the two-item Generalised Anxiety Disorder scale (GAD-2). BMJ Open, 8 (9). e023766. doi:10.1136/bmjopen-2018-023766
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Official URL: https://doi.org/10.1136/bmjopen-2018-023766
Abstract
Objective
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.
Design
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.
Setting
Inner-city maternity service, South London.
Participants
545 pregnant women were interviewed after their first antenatal appointment; 528 provided answers on the GAD-2 questions.
Main outcome measures
Diagnosis generated by the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th edition (SCID).
Results
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.
Conclusions
Anxiety disorders are common but GAD-2 generates many false positives and may therefore be unhelpful in maternity services.
| Item Type: | Journal Article | ||||||||||||||||||
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| Subjects: | R Medicine > RG Gynecology and obstetrics | ||||||||||||||||||
| Divisions: | Faculty of Medicine > Warwick Medical School > Health Sciences > Clinical Trials Unit Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School |
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| SWORD Depositor: | Library Publications Router | ||||||||||||||||||
| Library of Congress Subject Headings (LCSH): | Pregnant women -- Mental health, Anxiety disorders -- Statistics, Anxiety in women, Mental illness in pregnancy | ||||||||||||||||||
| Journal or Publication Title: | BMJ Open | ||||||||||||||||||
| Publisher: | BMJ Publishing Group | ||||||||||||||||||
| ISSN: | 2044-6055 | ||||||||||||||||||
| Official Date: | 4 September 2018 | ||||||||||||||||||
| Dates: |
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| Date of first compliant deposit: | 18 September 2018 | ||||||||||||||||||
| Volume: | 8 | ||||||||||||||||||
| Number: | 9 | ||||||||||||||||||
| Article Number: | e023766 | ||||||||||||||||||
| DOI: | 10.1136/bmjopen-2018-023766 | ||||||||||||||||||
| Status: | Peer Reviewed | ||||||||||||||||||
| Publication Status: | Published | ||||||||||||||||||
| Publisher Statement: | ** From BMJ via Jisc Publications Router. ** History: received 26-04-2018; rev-recd 10-07-2018; accepted 20-07-2018; ppub 09-2018; epub 04-09-2018. ** Licence for this article: https://creativecommons.org/licenses/by/4.0/ | ||||||||||||||||||
| Access rights to Published version: | Open Access | ||||||||||||||||||
| RIOXX Funder/Project Grant: |
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