Cited by 641Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychometric Methodologies and TestingMental Health Research Topics

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

Toussaint, Anne, Hüsing, Paul, Gumz, Antje, Wingenfeld, Katja, Härter, Martin, Schramm, Elisabeth, Löwe, Bernd·2020·Journal of Affective Disorders

DOI 10.1016/j.jad.2020.01.032

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Abstract

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 (GAD-7).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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Method
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“Abbreviations MPAI Mobile Phone Addiction Index scale GAD-7 The Chinese version of the seven-item Generalized Anxiety Inventory PSQI Pittsburgh Sleep Quality Index scale SD Standard Deviation Supplementary Information The online version contains supplementary material available at https://doi. org/10.1186/s12888-023-0…”
MethodInfluential
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Method
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“The MCID was calculated using a distribution-based approach [36], with GAD-7 change scores ≥ 4—approximately one standard deviation of the baseline mean score—set as the MCID threshold [37].”
Method
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“30 Finally, our results provide estimates of the sample size necessary to validate these results in future studies.”
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“Finally, minimal clinically important differences(MCID)werede ﬁ nedaschangesofatleast5pointsforthePHQ-9 scores 101 and at least 4 points for the GAD-7 scores 102 .”
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Authors: Toussaint, A., Hüsing, P., Gumz, A., Wingenfeld, K., Härter, M., Schramm, E., & Löwe, B.
Affiliations: University Medical Center Hamburg-Eppendorf (DE)
Charité – Universitätsmedizin Berlin (DE)
University of Freiburg (DE)
Corresponding author: Toussaint, Anne
ORCID: Toussaint, Anne
Hüsing, Paul
Gumz, Antje
Wingenfeld, Katja
Härter, Martin
Schramm, Elisabeth
Löwe, Bernd
Venue: Journal of Affective Disorders
Publisher: Elsevier BV
Published: 2020-03
Volume: 265
Pages: 395-401
ISSN: 0165-0327 (ISSN-L)
DOI: 10.1016/j.jad.2020.01.032
OpenAlex: W3000661394
Cited by: 641
References: 68
Citations by year: 2026: 134 · 2025: 138 · 2024: 113 · 2023: 99 · 2022: 68 · 2021: 59 · 2020: 30
FWCI: 61.87
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
doi.org/10.15223/policy-017 (stm-asf)
doi.org/10.15223/policy-037 (stm-asf)
doi.org/10.15223/policy-012 (stm-asf)
doi.org/10.15223/policy-029 (stm-asf)
doi.org/10.15223/policy-004 (stm-asf)
Locations: Journal of Affective Disorders (publishedVersion)
PubMed (publishedVersion)
Funders: Deutsche Forschungsgemeinschaft
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
Keywords: GAD-7, Generalized Anxiety Disorder Scale, anxiety symptoms, chronic depression, sensitivity to change, minimal clinically important difference, standardized response mean, treatment response monitoring, Hamilton Depression Rating Scale
MeSH terms: Minimal Clinically Important Difference, Patient Health Questionnaire, Anxiety Disorders, Depression, Humans, Treatment Outcome

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

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