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01.12.2012 | Research | Ausgabe 1/2012 Open Access

Health and Quality of Life Outcomes 1/2012

The assessment of generalized anxiety disorder: psychometric validation of the Spanish version of the self-administered GAD-2 scale in daily medical practice

Health and Quality of Life Outcomes > Ausgabe 1/2012
Javier García-Campayo, Enric Zamorano, Miguel A Ruiz, María Pérez-Páramo, Vanessa López-Gómez, Javier Rejas
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1477-7525-10-114) contains supplementary material, which is available to authorized users.

Competing interests

Vanessa López-Gómez, María Pérez and Javier Rejas are full-time employees of Pfizer, S.L.U. Miguel Ruiz is a professor at the Universidad Autónoma de Madrid which was engaged to perform analysis of data and drafting of a preliminary version of the manuscript. All other authors declare that they do not have conflicts of interest as a consequence of this paper.

Authors’ contributions

The authors of this manuscript state that they all contributed substantially to manuscript preparation, interpretation of results or study design and logistics. JGC, EZ, MR, VLG, MP and JR were responsible for the study design. JGC and EZ participated in data collection, interpretation of data and manuscript drafting. MR performed data analysis and interpretation. MP and VLG participated in interpretation of data and drafting of the manuscript. All authors approved the final manuscript.



To psychometrically validate the Spanish version of the self-administered 2-item GAD-2 scale for screening probable patients with generalised anxiety disorder (GAD).


The GAD-2 was self-administered by patients diagnosed with GAD according to DSM-IV criteria and by age- and sex-matched controls who were recruited at random in mental health and primary care centres. Criteria validity was explored using ROC curve analysis, and sensitivity, specificity and positive and negative predictive values were determined for different cut-off values. Concurrent validity was also established using the HAM-A, HADS, and WHODAS II scales.


The study sample consisted of 212 subjects (106 patients with GAD) with a mean age of 50.38 years (SD = 16.76). No items of the scale were left blank. Floor and ceiling effects were negligible. No patients with GAD had to be assisted to complete the questionnaire. Reliability (internal consistency) was high; Cronbach’s α = 0.875. A cut-off point of 3 showed adequate sensitivity (91.5%) and specificity (85.8%), with a statistically significant area under the curve (AUC = 0.937, p < 0.001), to distinguish GAD patients from controls. Concurrent validity was also high and significant with HAM-A (0.806, p < 0.001), HADS (anxiety domain, 0.825, p < 0.001) and WHO-DAS II (0.642, p < 0.001) scales.


The Spanish version of the GAD-2 scale has been shown to have appropriate psychometric properties to rapidly detect probable cases of GAD in the Spanish cultural context under routine clinical practice conditions.
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