4.7 Article

Sensitivity to change and minimal clinically important difference of the 7-item Generalized Anxiety Disorder Questionnaire (GAD-7)

Journal

JOURNAL OF AFFECTIVE DISORDERS
Volume 265, Issue -, Pages 395-401

Publisher

ELSEVIER
DOI: 10.1016/j.jad.2020.01.032

Keywords

Psychometrics; Anxiety; Responsiveness; Sensitivity to change; Minimal clinically important difference

Funding

  1. German Research Foundation [SCHR443/11-1]

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Background: Effective treatment requires regular follow-up and monitoring of symptoms. We investigated sensitivity to change and minimal clinically important difference of the Generalized Anxiety Disorder Scale (GAD7). Methods: This study included all participants from a multisite trial of chronic depression. Baseline and follow-up (12 and 48 weeks) data were used to assess treatment response. Effect sizes (ES) and standardized response means (SRM) of pre- and post-GAD-7 mean changes were calculated for subgroups of patients, who did or did not improve according to ratings in the Hamilton Rating Scale for Depression (HRSD-24). Results: N = 261 patients were included in the analyses. In the subgroup of patients who improved according to HRSD-24, GAD-7 scores were significantly lower after 12 weeks (t = - 6.31, df = 120, p < .001; ES = - 0.51, SRM = - 0.57), and 48 weeks of treatment (t = - 12.68, df = 141, p < .001; ES = -1.0, SRM = -1.7), when compared to admission. In the group who worsened, GAD-7 scores were significantly higher after 12 weeks (t = 2.96, df = 41, p = .005; ES = 0.30, SRM = 0.46), and increased after 48 weeks (t = 1.99, df = 21, p = .059; ES = 0.37, SRM = 0.43), when compared to baseline. The unchanged group showed no significant difference between baseline and follow-up. MCID was estimated 4 points on the GAD-7 total score. Limitations: Confirmation of these findings and further investigation of the GAD-7 in populations and trials focusing on anxiety-specific treatment is highly recommended. Conclusions: Results show that the GAD-7 is sensitive to detect change in psychopathology over the course of treatment.

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