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The validity and reliability of screening measures for depression and anxiety disorders in multiple sclerosis
Open accessAbstract
OBJECTIVE: We aimed to evaluate the validity and reliability of multiple screening measures for depression and anxiety for use in the clinical care of people with multiple sclerosis (MS). METHODS: Participants with MS completed the Patient Health Questionnaire (PHQ-9), Hospital Anxiety and Depression Scale (HADS), Kessler-6 Distress Scale, PROMIS Emotional Distress Depression Short-Form 8a (PROMIS Depression) and Anxiety Short-Form 8a (PROMIS Anxiety), Generalized Anxiety Disorder 7-item Scale (GAD-7), and the Overall Anxiety and Severity Impairment Scale (OASIS). A subgroup repeated the screening measures two weeks later. All participants also completed a Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID). For the screening measures we computed sensitivity, specificity, positive predictive and negative predictive value with SCID diagnoses as the reference standard and conducted receiver operating curve (ROC) analyses; we also assessed internal consistency and test-retest reliability. RESULTS: Of 253 participants, the SCID classified 10.3% with major depression and 14.6% with generalized anxiety disorder. Among the depression measures, the PHQ-9 had the highest sensitivity (84%). Specificity was generally higher than sensitivity, and was highest for the HADS-D with a cut-point of 11 (95%). In ROC analyses the area under the curve (AUC) did not differ between depression measures. Among the anxiety measures, sensitivity was highest for the HADS-A with a cut-point of 8 (82%). Specificity ranged from 83% to 86% for all measures except the HADS-A with a cut-point of 8 (68%). The AUC did not differ between anxiety measures. CONCLUSION: Overall, performance of the depression and anxiety screening measures was very similar, with reasonable psychometric properties for the MS population, suggesting that other factors such as accessibility and ease of use could guide the choice of measure in clinical practice.
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“Validity and reliability of this measure have been demonstrated in patients with knee osteoarthritis (Driban, Morgan, Price, Cook, & Wang, 2015), multiple sclerosis (Marrie et al., 2018), and lumbar degenerative disease (Purvis, Neuman, Riley, & Skolasky, 2018).”
From Patient-Reported Outcomes Measurement Information System (PROMIS) Instruments: Reliability and Validity in Veterans Following Orthopedic Surgery. (2020) · cites this paper as Marrie et al., 2018
In the citing paper
“Validity and reliability of this measure have been demonstrated in patients with knee osteoarthritis (Driban et al., 2015), multiple sclerosis (Marrie et al., 2018), and lumbar degenerative disease (Purvis et al., 2018)”
From Patient-Reported Outcomes Measurement Information System (PROMIS) Instruments: Reliability and Validity in Veterans Following Orthopedic Surgery. (2020) · cites this paper as Marrie et al., 2018
In the citing paper
“It is widely used in outpatient, hospital, and community settings, and has been validated for use in pwMS (Marrie et al., 2018).”
From Neuropsychology intervention for managing invisible symptoms of MS (NIMIS-MS) group: A pilot effectiveness and acceptability study (2024) · cites this paper as Marrie et al., 2018
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Metadata
- Authors
- Marrie, R. A., Zhang, L., Lix, L. M., Graff, L. A., Walker, J. R., Fisk, J. D., Patten, S. B., Hitchon, C. A., Bolton, J. M., Sareen, J., El-Gabalawy, R., Marriott, J. J., & Bernstein, C. N.
- Affiliations
- University of Manitoba (CA)
- Dalhousie University (CA)
- University of Calgary (CA)
- Corresponding author
- Marrie, Ruth Ann
- ORCID
- Venue
- Multiple Sclerosis and Related Disorders
- Publisher
- Elsevier BV
- Published
- 2018-02
- Volume
- 20
- Pages
- 9-15
- ISSN
- 2211-0348 (ISSN-L)
- OpenAlex
- W2771966364
- Cited by
- 169
- References
- 40
- Citations by year
- 2026: 17 · 2025: 17 · 2024: 16 · 2023: 25 · 2022: 22 · 2021: 26 · 2020: 18 · 2019: 24 · 2018: 4
- FWCI
- 16.26
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Multiple Sclerosis and Related Disorders (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- Crohn's and Colitis Canada
- Heart and Stroke Foundation of Canada
- Canadian Institutes of Health Research (THC-135234, 333252)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Clinical Neurology › Multiple Sclerosis Research Studies
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Keywords
- multiple sclerosis, depression screening, anxiety screening, PHQ-9, Hospital Anxiety and Depression Scale, PROMIS, GAD-7, OASIS, Kessler-6, sensitivity and specificity, test-retest reliability, internal consistency, psychometric properties, generalized anxiety disorder
- MeSH terms
- Anxiety, Depression, Female, Humans, Interview, Psychological, Male, Middle Aged, Multiple Sclerosis, Psychiatric Status Rating Scales, Psychometrics, Sensitivity and Specificity, Reproducibility of Results
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