Background
Aims of the study
Methods
Procedure
Sampling of GPs
Sampling of patients
Variables | DSQ/HADS sample N = 1,385 | GAS-Q/HADS sample N = 1,238 |
---|---|---|
Age, mean (SD): | ||
Female | 45.7 (17.3) | 45.2 (17.1) |
Male | 49.8 (17.3) | 50.0 (17.7) |
N (%)
|
N (%)
| |
Gender: | ||
Female | 886 (64.0) | 783 (63.2) |
Male | 499 (36.0) | 455 (36.8) |
Civil status: | ||
Married /paired relationship | 934 (68.0) | 848 (68.9) |
Living alone | 440 (32.0) | 383 (31.1) |
On sick leave: | ||
Yes | 248 (20.2) | 208 (18.9) |
No | 980 (79.8) | 893 (81.1) |
Prevalence rates: | ||
DSQ / GAS-Q positive | 125 (9.0) | 73 (5.9) |
HADS-D / HADS-A (≥ 8) | 256 (18.5) | 357 (28.8) |
CGI-S (dep / gad, ≥ 3) | 337 (24.3) | 217 (17.5) |
Diagnostic criteria and instruments
Statistical methods
Ethics
Results
Prevalence rates
Psychometrics of the HADS
Case-finding abilities of the HADS
Generalized Anxiety Disorder (N = 1,238) | Major Depressive Episode (N = 1,385) | ||||||
---|---|---|---|---|---|---|---|
Score | N (%) | Sensitivity | Specificity | N (%) | Sensitivity | Specificity | |
HADS – A/D
|
5
| 637 (51.5) | 0.99 | 0.52 | 463 (33.4) | 0.94 | 0.73 |
6
| 528 (42.6) | 0.97 | 0.61 | 384 (27.7) | 0.89 | 0.78 | |
7
| 444 (35.9) | 0.92 | 0.68 | 301 (21.7) | 0.83 | 0.84 | |
8
| 357 (28.8) | 0.89 | 0.75 | 256 (18.5) | 0.80 | 0.88 | |
9
| 296 (23.9) | 0.85 | 0.80 | 201 (14.4) | 0.74 | 0.91 | |
10
| 236 (19.1) | 0.71 | 0.84 | 156 (11.3) | 0.68 | 0.94 | |
11
| 198 (16.0) | 0.64 | 0.87 | 118 (8.5) | 0.61 | 0.97 | |
12
| 157 (12.7) | 0.58 | 0.90 | 91 (6.6) | 0.50 | 0.98 | |
13
| 127 (10.3) | 0.47 | 0.92 | 64 (4.6) | 0.36 | 0.99 | |
14
| 95 (7.7) | 0.34 | 0.94 | 41 (3.0) | 0.26 | 0.99 | |
CGI-S
|
2
| 314 (25.4) | 0.74 | 0.78 | 529 (38.2) | 0.93 | 0.63 |
3
| 217 (17.5) | 0.52 | 0.85 | 337 (24.3) | 0.79 | 0.81 | |
4
| 141 (11.4) | 0.38 | 0.90 | 208 (15.0) | 0.64 | 0.90 | |
5
| 20 (1.6) | 0.08 | 0.99 | 29 (2.1) | 0.14 | 0.99 | |
6
| 2 (0.2) | 0.00 | 1.00 | 2 (0.1) | 0.02 | 1.00 |
Comparison of GP-rated and patient-rated case identification
Generalized Anxiety Disorder (GAS-Q Positive 73/1,238 = 5.9%) | Major Depressive Episode (DSQ Positive 125/1,385 = 9.0%) | |||
---|---|---|---|---|
Patients' HADS-A ≥ 8 | GPs' CGI-S ≥ 3 | Patients' HADS-D ≥ 8 | GPs' CGI-S ≥ 3 | |
Sensitivity / Specificity | 0.89 / 0.75 | 0.52 / 0.85 | 0.80 / 0.88 | 0.79 / 0.81 |
Classification
|
% (95% CI)
|
% (95% CI)
|
% (95% CI)
|
% (95% CI)
|
True positive disorder | 5.3 (4.1–6.5)* | 3.1 (2.1–4.1) | 7.2 (5.8–8.6) | 7.1 (5.7–8.5) |
False positive disorder | 23.5 (21.1–25.9)* | 14.1 (12.2–16.0) | 10.9 (9.3–12.5) | 17.3 (15.3–19.3)* |
Observed disordered | 28.8 (26.3–31.3)* | 17.2 (15.1–19.3) | 18.1 (16.1–20.1) | 24.4 (22.1–26.7)* |
True positive healthy | 70.6 (68.1–73.1) | 80.0 (77.8–82.2)* | 80.1 (78.0–82.2)* | 73.7 (71.4–76.0) |
False positive healthy | 0.6 (0.2–1.0) | 2.8 (1.9–3.7)* | 1.8 (1.1–2.5) | 1.9 (1.2–2.6) |
Observed healthy | 71.2 (68.7–73.7) | 82.8 (80.7–84.9)* | 81.9 (79.9–83.9)* | 75.6 (73.3–77.9) |
Total rightly classified | 75.9 (73.5–78.3) | 83.1 (81.0–85.2)* | 87.3 (85.5–89.1)* | 80.8 (78.7–82.9) |
Total wrongly classified | 24.1 (21.7–26.5)* | 16.9 (14.8–19.0) | 12.7 (10.9–14.5) | 19.2 (17.1–21.3)* |