Screening for anxiety in patients with cancer: Diagnostic accuracy of GAD-7 items considering lowered GAD-7 cut-offs.
<h4>Background</h4>A standard questionnaire for generalized anxiety disorders is the GAD-7. Attempts to improve its screening capacity in oncological settings resulted in a discussion about lowering its cut-off. This study examines the diagnostic accuracy of the GAD-7 items depending on...
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| Format: | Article |
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Public Library of Science (PLoS)
2025-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0316853 |
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| author | Miriam Grapp Till J Bugaj Valentin Terhoeven Hans-Christoph Friederich Imad Maatouk |
| author_facet | Miriam Grapp Till J Bugaj Valentin Terhoeven Hans-Christoph Friederich Imad Maatouk |
| author_sort | Miriam Grapp |
| collection | DOAJ |
| description | <h4>Background</h4>A standard questionnaire for generalized anxiety disorders is the GAD-7. Attempts to improve its screening capacity in oncological settings resulted in a discussion about lowering its cut-off. This study examines the diagnostic accuracy of the GAD-7 items depending on applied cut-offs and whether, similar to depressive symptoms, a distinction between somatic-emotional and cognitive items might be relevant.<h4>Patients and methods</h4>Screening data from 4705 patients with cancer who were treated at the outpatient clinic of the National Centre for Tumour Diseases in Heidelberg were analysed. For the individual GAD-7 items sensitivity, specificity, positive and negative predictive values, and Clinical Utility Index were determined for cut-off ≥ 7, ≥ 8, ≥ 10 and ≥ 15 in the GAD-7 questionnaire.<h4>Results</h4>The best overall diagnostic accuracy was found for a cut-off ≥ 8. The cognitive items had the best diagnostic accuracy for identifying severe GAD (cut-off ≥ 15), and the somatic-emotional items had the best diagnostic accuracy for identifying mild to moderate GAD (cut-off ≥ 7, ≥ 8 and ≥ 10).<h4>Conclusions</h4>Our data support the recommendation of lowering the GAD-7 cut-off in oncology settings and suggest that in anxiety disorders, a symptom overlap between the physical illness and a possible mental disorder should be considered. |
| format | Article |
| id | doaj-art-56f9c8b6555a4cfeb0c23c9260bd9132 |
| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLoS ONE |
| spelling | doaj-art-56f9c8b6555a4cfeb0c23c9260bd91322025-02-05T05:31:27ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01201e031685310.1371/journal.pone.0316853Screening for anxiety in patients with cancer: Diagnostic accuracy of GAD-7 items considering lowered GAD-7 cut-offs.Miriam GrappTill J BugajValentin TerhoevenHans-Christoph FriederichImad Maatouk<h4>Background</h4>A standard questionnaire for generalized anxiety disorders is the GAD-7. Attempts to improve its screening capacity in oncological settings resulted in a discussion about lowering its cut-off. This study examines the diagnostic accuracy of the GAD-7 items depending on applied cut-offs and whether, similar to depressive symptoms, a distinction between somatic-emotional and cognitive items might be relevant.<h4>Patients and methods</h4>Screening data from 4705 patients with cancer who were treated at the outpatient clinic of the National Centre for Tumour Diseases in Heidelberg were analysed. For the individual GAD-7 items sensitivity, specificity, positive and negative predictive values, and Clinical Utility Index were determined for cut-off ≥ 7, ≥ 8, ≥ 10 and ≥ 15 in the GAD-7 questionnaire.<h4>Results</h4>The best overall diagnostic accuracy was found for a cut-off ≥ 8. The cognitive items had the best diagnostic accuracy for identifying severe GAD (cut-off ≥ 15), and the somatic-emotional items had the best diagnostic accuracy for identifying mild to moderate GAD (cut-off ≥ 7, ≥ 8 and ≥ 10).<h4>Conclusions</h4>Our data support the recommendation of lowering the GAD-7 cut-off in oncology settings and suggest that in anxiety disorders, a symptom overlap between the physical illness and a possible mental disorder should be considered.https://doi.org/10.1371/journal.pone.0316853 |
| spellingShingle | Miriam Grapp Till J Bugaj Valentin Terhoeven Hans-Christoph Friederich Imad Maatouk Screening for anxiety in patients with cancer: Diagnostic accuracy of GAD-7 items considering lowered GAD-7 cut-offs. PLoS ONE |
| title | Screening for anxiety in patients with cancer: Diagnostic accuracy of GAD-7 items considering lowered GAD-7 cut-offs. |
| title_full | Screening for anxiety in patients with cancer: Diagnostic accuracy of GAD-7 items considering lowered GAD-7 cut-offs. |
| title_fullStr | Screening for anxiety in patients with cancer: Diagnostic accuracy of GAD-7 items considering lowered GAD-7 cut-offs. |
| title_full_unstemmed | Screening for anxiety in patients with cancer: Diagnostic accuracy of GAD-7 items considering lowered GAD-7 cut-offs. |
| title_short | Screening for anxiety in patients with cancer: Diagnostic accuracy of GAD-7 items considering lowered GAD-7 cut-offs. |
| title_sort | screening for anxiety in patients with cancer diagnostic accuracy of gad 7 items considering lowered gad 7 cut offs |
| url | https://doi.org/10.1371/journal.pone.0316853 |
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