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Validation of the Generalized Anxiety Disorder-7 (GAD-7) and GAD-2 in patients with migraine
Open accessAbstract
BACKGROUND: Psychiatric problems have been commonly reported in patients with migraine. This study investigated the reliability and validity of the Generalized Anxiety Disorder-7 (GAD-7) and Generalized Anxiety Disorder-2 (GAD-2) in patients with migraine. METHODS: Subjects were recruited from a headache clinic and a neuropsychologist examined their GAD using the Mini International Neuropsychiatric Interview-Plus Version 5.0.0 (MINI). Subjects completed several instruments, including the GAD-7, the Beck Anxiety Inventory (BAI), the Migraine Disability Assessment Scale (MIDAS), the Headache Impact Test-6 (HIT-6), and the Migraine-Specific Quality of Life (MSQoL). RESULTS: Among 146 participants, 32 patients (21.9 %) had GAD as determined by the MINI. Cronbach's α for the GAD-7 and GAD-2 were 0.915 and 0.820, respectively. At a cutoff score of 5, the GAD-7 had a sensitivity of 78.1 %, a specificity of 74.6 %, a positive predictive value (PPV) of 46.3 %, and a negative predictive value (NPV) of 92.4 %. At a cutoff score of 1, the GAD-2 had a sensitivity of 84.4 %, a specificity of 72.8 %, a PPV of 46.6 %, and a NPV of 94.3 %. The scores of the GAD-7 and GAD-2 well correlated with the BAI score, the MIDAS score, the HIT-6 score, and the MSQoL score. CONCLUSIONS: The GAD-7 and GAD-2 are both reliable and valid screening instruments for GAD in patients with migraine.
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“The GAD-7 has shown strong internal consistency (Cronbach’s α = 0.92) [57] and is validated for chronic pain patients with migraine [58].”
From ACTsmart: Guided Smartphone-Delivered Acceptance and Commitment Therapy for Chronic Pain—A Pilot Trial. (2021) · cites this paper as [58]
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Impaired functional connectivity of limbic system in migraine without aura
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“Anxiety was assessed using the General Anxiety Disorder-7 (GAD-7), and a score of > 5 was identified as the presence of anxiety [26].”
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“—Symptoms of anxiety were assessed using the Generalized Anxiety Disorder-7 (GAD-7), which has been shown to be a reliable and valid screening instrument for anxiety in patients with migraine.(25) The GAD-7 consists of 7 questions, each of which is scored from 0 (“not at all”) to 3 (“almost all the time”).”
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“At the baseline visit, the patients completed self-reported questionnaires including the Headache Impact Test-6 (HIT-6) (11) and Migraine Disability Assessment Test (MIDAS) (12) for life impact assessment due to headaches and Generalized Anxiety Disorder-7 (GAD-7) (13), and the Patient Health Questionnaire-9 (PHQ-9) (…”
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“The Korean version of the GAD-7 is a valid and reliable measurement [21].”
Ajith, B., Najeeb, N., John, A., & Anima, V. (2022) · Indian Journal of Ophthalmology · doi:10.4103/ijo.ijo_1389_21 · Cited by 26
“[15] The GAD‐7 questionnaire that was used to screen for anxiety includes seven questions and calculated scores from 0 to 3 for every response given by the patient.[16] Scores of 5, 10, and 15 are taken as cut‐off points for mild, moderate, and severe anxiety, respectively.”
MethodTemporal changes of circadian rhythmicity in cluster headache
Lee, M. J., Cho, S., Park, J. W., Chu, M. K., Moon, H., Chung, P., Chung, J.-M., Sohn, J., Kim, B., Kim, B., et al. (2019) · Cephalalgia · doi:10.1177/0333102419883372 · Cited by 26
“Comorbid depression and anxiety were assessed using the Korean version of the Patient Health Questionnaire-9 (PHQ-9) and the General Anxiety Disorder-7 item scale (GAD-7) (14,15).”
MethodLu, Y., Li, Y., Huang, Y., Zhang, X., Wang, J., Wu, L., & Cao, F. (2023) · Journal of Medical Internet Research · doi:10.2196/51549 · Cited by 24
“Following previous research [40], we adopted a cutoff score of 5 to identify nurses with mild or greater anxiety symptoms for the intervention purpose.”
Vægter, H. B., Ussing, K., Johansen, J. V., Stegemejer, I., Palsson, T. S., O’Sullivan, P., & Kent, P. M. (2019) · PAIN Reports · doi:10.1097/pr9.0000000000000802 · Cited by 25
Correlates of continued cannabis use during pregnancy
Pike, C. K., Sofis, M. J., & Budney, A. J. (2021) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2021.108939 · Cited by 25
Song, T., Lee, M. J., Choi, Y.-J., Kim, B., Chung, P., Park, J.-W., Chu, M. K., Kim, B., Sohn, J., Oh, K., et al. (2019) · Journal of Clinical Neurology · doi:10.3988/jcn.2019.15.3.334 · Cited by 24
Rosgen, B. K., Krewulak, K. D., Davidson, J. E., Ely, E. W., Stelfox, H. T., & Fiest, K. M. (2021) · BMC Psychiatry · doi:10.1186/s12888-021-03200-7 · Cited by 24
“Abbreviations ICU: Intensive care unit; GAD-7: Generalized Anxiety Disorder 7; PHQ-9: Patient Health Questionnaire 9; DSM-IV: Diagnostic and Statistical Manual of Mental Disorders, 4th Edition; APACHE-II: Acute Physiology and Chronic Health Evaluation II Acknowledgements The authors would like to thank Israt Yasmeen a…”
BackgroundMethodInfluentialScreening for epilepsy-specific anxiety symptoms: French validation of the EASI
Micoulaud‐Franchi, J., Kotwas, I., Arthuis, M., Soncin, L., Rontani, P., Daquin, G., Cermolacce, M., Bartoloméi, F., & McGonigal, A. (2022) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2022.108585 · Cited by 24
Predicting Suicidal Ideation in College Students with Mental Health Screening Questionnaires
Shim, G., & Jeong, B. (2018) · Psychiatry Investigation · doi:10.30773/pi.2018.08.21.3 · Cited by 24
Psychiatric comorbidities of migraine
(2024) · Handbook of Clinical Neurology · doi:10.1016/b978-0-12-823357-3.00013-6 · Cited by 25
Gentili, C., Zetterqvist, V., Rickardsson, J., Holmström, L., Simons, L. E., & Wicksell, R. K. (2021) · Pain Medicine · doi:10.1093/pm/pnaa360 · Cited by 20
“92) [57] and is validated for chronic pain patients with migraine [58].”
BackgroundPsychometric properties of the generalized anxiety disorder-7 (GAD-7) in a sample of workers
Merino‐Soto, C., Angulo-Ramos, M., Rovira-Millán, L. V., & Rosario-Hernández, E. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.999242 · Cited by 28
Foley, J., Jones, F. W., Hassett, A., & Williams, E. P. (2023) · The Police Journal Theory Practice and Principles · doi:10.1177/0032258x231183638 · Cited by 24
“The PHQ-9 is widely used and has demonstrated high levels of reliability and validity for identifying current levels of depression (e.g. Beard et al., 2016; Kocalevent et al., 2013; Martin et al., 2006; Seo and Park, 2015b).”
Kim, Y.-S., Park, Y., Cho, G., Park, K., Kim, S.-H., Baik, S. Y., Kim, C. L., Jung, S., Lee, W.-H., Choi, Y., et al. (2018) · Psychiatry Investigation · doi:10.30773/pi.2018.09.27.2 · Cited by 22
Cho, S., Lee, M. J., Kim, B., Moon, H., Chung, P.-W., Sohn, J.-H., Kim, S. K., Choi, Y., Song, T., Kim, J. M., et al. (2019) · PLoS ONE · doi:10.1371/journal.pone.0221155 · Cited by 22
Tran, A. G. T. T. (2020) · The Sport Psychologist · doi:10.1123/tsp.2020-0028 · Cited by 26
Alshammari, T. K., Alkhodair, A. M., Alhebshi, H. A., Rogowska, A. M., Albaker, A. B., Aldamri, N. T., Dayel, A. F. B., Alonazi, A. S., Al-Rasheed, N. M., & Alshammari, M. A. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19106262 · Cited by 22
Yun, J.-A., Huh, H.-J., Han, H.-S., Huh, S., & Chae, J.-H. (2018) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2017.12.007 · Cited by 21
Kim, K., Yang, J. S., Jeon, Y. J., Lee, Y. J., Lee, Y., Kim, H. C., Koenen, K. C., Kim, Y., & Jung, S. J. (2021) · Epidemiology and Health · doi:10.4178/epih.e2021085 · Cited by 23
“Korean versions of the PHQ-9 [26], GAD-7 [27], and PCL-5 [28] have been validated in previous studies for use with the Korean population.”
MethodAhmadi, S. M., Arani, A. M., Bakhtiari, M., & Emamy, M. H. D. (2020) · Iranian Journal of Psychiatry and Behavioral Sciences · doi:10.5812/ijpbs.85820 · Cited by 21
“The GAD-2 well correlated with the beck anxiety inventory (BAI), and the Migraine Disability Assessment scale (MIDAS) (23).”
MethodClinical factors influencing the impact of cluster headache from a prospective multicenter study
Sohn, J., Park, J., Lee, M. J., Chung, P., Chu, M. K., Chung, J. M., Ahn, J. Y., Kim, B., Kim, S. K., Choi, Y.-J., et al. (2020) · Scientific Reports · doi:10.1038/s41598-020-59366-9 · Cited by 22
The role of psychosocial risk factors in the burden of headache
Malmberg-Céder, K., Haanpää, M. L., Korhonen, P. E., Kautiainen, H., Veromaa, V., & Soinila, S. O. (2019) · Journal of Pain Research · doi:10.2147/jpr.s165263 · Cited by 21
“The HIT-6 has also been used as a reference in validation of anxiety questionnaires.(18) Furthermore, correlation of the HIT-6 score with the severity of depression and correlation of depression with psychosocial parameters in headache patients have been reported.”
MethodThe Association between High-Caffeine Drink Consumption and Anxiety in Korean Adolescents
Cho, J., Kim, S. Y., Shin, H., Kim, H., & Park, E. (2024) · Nutrients · doi:10.3390/nu16060794 · Cited by 31
“The Korean version of the GAD-7, translated by Seo et al. [28], demonstrated a Cronbach’s α of 0.915.”
MethodInfluentialAggression and its association with suicidality in migraine patients: a case-control study
Park, S.-P., & Seo, J.-G. (2018) · The Journal of Headache and Pain · doi:10.1186/s10194-018-0903-x · Cited by 20
“Seo JG, Park SP (2015) Validation of the generalized anxiety Disorder-7 (GAD-7) and GAD-2 in patients with migraine.”
MethodInfluentialLee, S. J., Jin, X., & Lee, S. (2021) · Journal of Korean Biological Nursing Science · doi:10.7586/jkbns.2021.23.2.110 · Cited by 20
Manzar, M. D., Alghadir, A. H., Anwer, S., Alqahtani, M. M., Mohammed, S., Addo, H. A., Jifar, W. W., & Alasmee, N. (2021) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s295912 · Cited by 21
“One such screening instrument is the generalized anxiety disorders – 7 scale (GAD-7),(6) which has been validated in different populations previously.(7,8) The GAD-7 is a brief and easy-to-use instrument designed to assess the symptoms of GAD as described in the Diagnostic and Statistical Manual of Mental Disorders-IV…”
MethodPu, J., Zhou, W., Zeng, W., & Shang, S. (2023) · Age and Ageing · doi:10.1093/ageing/afad190 · Cited by 19
Seo, J.-G., & Park, S.-P. (2018) · Neurological Sciences · doi:10.1007/s10072-018-3661-2 · Cited by 19
Cortez, M. M., Millsap, L., Rea, N., Sciarretta, C., & Brennan, K. C. (2021) · Cephalalgia · doi:10.1177/03331024211010304 · Cited by 19
“For this study, we used the GAD-7 to measure anxietyrelated symptoms, which has been validated in chronic headache disorders (18) and is reasonably sensitive and specific for PTSD-related anxiety (39).”
MethodLiu, P., Chen, H., Tong, B., Zhu, D., Cong, X. S., & Shang, S. (2024) · Aging Clinical and Experimental Research · doi:10.1007/s40520-024-02764-0 · Cited by 21
Metadata
- Authors
- Seo, J.-G., & Park, S.-P.
- Affiliations
- Kyungpook National University (KR)
- Corresponding author
- Park, Sung-Pa
- Venue
- The Journal of Headache and Pain
- Published
- 2015-11-23
- Volume
- 16
- Issue
- 1
- Pages
- 97-97
- ISSN
- 1129-2369 (ISSN-L)
- 1129-2377
- PMC
- PMC4656257
- OpenAlex
- W2173864200
- Cited by
- 341
- References
- 30
- Citations by year
- 2026: 40 · 2025: 36 · 2024: 53 · 2023: 46 · 2022: 36 · 2021: 49 · 2020: 26 · 2019: 25 · 2018: 19 · 2017: 3 · 2016: 8
- FWCI
- 8.11
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- The Journal of Headache and Pain (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Clinical Neurology › Migraine and Headache Studies
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Nursing › Research and Theory › Health Education and Validation
- Keywords
- Generalized Anxiety Disorder-7, GAD-2, generalized anxiety disorder, migraine, anxiety screening, psychometric validation, reliability statistics, sensitivity and specificity, migraine disability, migraine-related quality of life, headache impact
- MeSH terms
- Adolescent, Adult, Aged, Anxiety Disorders, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Migraine Disorders, Psychiatric Status Rating Scales, Psychometrics, Sensitivity and Specificity, Reproducibility of Results, Comorbidity, Young Adult
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