Brief case finding tools for anxiety disorders: Validation of GAD-7 and GAD-2 in addictions treatment
Abstract
Background Anxiety disorders are the most common mental health problems and often co-exist with substance use. Little evidence exists to support the use of brief screening tools for anxiety disorders in routine addictions treatment. This is the first study to test the validity and reliability of GAD-7 and GAD-2 in an outpatient drugs treatment population.Methods A sample of 103 patients completed brief screening questionnaires and took part in structured diagnostic assessments using CIS-R. A subgroup of 60 patients completed retests after 4 weeks. The results of brief questionnaires were compared to those of gold-standard diagnostic interviews using Receiver Operating Characteristic (ROC) curves. Psychometric properties were also calculated to evaluate the validity and reliability of self-completed questionnaires.Results A GAD-7 score ≥ 9 had a sensitivity of 80% and specificity of 86% for any anxiety disorder, also displaying adequate temporal stability at repeated measurements (intra-class correlation=0.85) and high internal consistency (Cronbach's alpha=0.91). A GAD-2 score ≥ 2 had 94% sensitivity and 53% specificity, with adequate internal consistency (0.82).Conclusions GAD-7 adequately detected the presence of an anxiety disorder in drug and alcohol users; although this study was limited by sample size to determine its reliability for specific diagnoses. Results in this small sample suggest that GAD-7 may be a useful screening tool in addiction services, although replication in a larger sample is warranted.
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Studies in many areas have demonstrated that psychotherapy RCTs are feasible.
“studies in many areas have demonstrated that psychotherapy RCTs are feasible [46-48].”
From A prospective service evaluation of acceptance and commitment therapy for patients with refractory epilepsy (2015) · cites this paper as [46]
The GAD-7 optimal cut-off was 10 or greater.
“The GAD-7 in this study had an optimal cut off score of 10 or greater, similar to the previously validated cut-off of nine and above in general psychiatry (Löwe et al., 2008) and nine and above in a substance use disorder specific population (Delgadillo et al., 2012).”
From Optimizing screening for depression, anxiety disorders, and post-traumatic stress disorder in inpatient addiction treatment: A preliminary investigation (2021) · cites this paper as Delgadillo et al., 2012
Only one prior validation of the PHQ-9 and GAD-7 exists in a substance use disorder sample, and it was outpatient.
“In fact, to our knowledge the PHQ-9 and the GAD-7 have only been validated once in a SUD population and that was in an outpatient setting (Delgadillo et al., 2011; Delgadillo et al., 2012).”
From Optimizing screening for depression, anxiety disorders, and post-traumatic stress disorder in inpatient addiction treatment: A preliminary investigation (2021) · cites this paper as Delgadillo et al., 2012
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- Authors
- Delgadillo, J., Payne, S., Gilbody, S., Godfrey, C., Gore, S., Jessop, D., & Dale, V.
- Affiliations
- Leeds Community Healthcare NHS Trust (GB)
- Western Health and Social Care Trust (GB)
- University of York (GB)
- Venue
- Drug and Alcohol Dependence
- Publisher
- Elsevier BV
- Published
- 2012-09
- Volume
- 125
- Issue
- 1-2
- Pages
- 37-42
- ISSN
- 0376-8716 (ISSN-L)
- OpenAlex
- W2047983963
- Cited by
- 106
- References
- 58
- Citations by year
- 2026: 5 · 2025: 15 · 2024: 9 · 2023: 11 · 2022: 9 · 2021: 14 · 2020: 6 · 2019: 7 · 2018: 6 · 2017: 2 · 2016: 7 · 2015: 8 · 2014: 4 · 2013: 2 · 2012: 1
- FWCI
- 6.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Drug and Alcohol Dependence (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- anxiety disorders, GAD-7, GAD-2, Generalized Anxiety Disorder Scale, screening tool, brief screening, addiction treatment, substance use disorders, psychometric validation, sensitivity and specificity, temporal stability, internal consistency
- MeSH terms
- Adult, Anxiety Disorders, Cross-Sectional Studies, Female, Humans, Male, Neuropsychological Tests, Outpatients, Psychometrics, Surveys and Questionnaires, ROC Curve, Reproducibility of Results, Area Under Curve, Substance-Related Disorders, International Classification of Diseases, Diagnostic and Statistical Manual of Mental Disorders
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