The FEAR: A rapid screening instrument for generalized anxiety in elderly primary care attenders

Author(s): Ryan, P., Ertan, T., Howard, R., Lindesay, J., Mann, A.

Journal/Book: Int J Geriat Psychiat. 1999; 14: Baffins Lane Chichester, W Sussex PO19 1UD, England. John Wiley & Sons Ltd. 60-68.

Abstract: Objective. To develop a shorter version of the Anxiety Disorder Scale (ADS) for use as a rapid screening instrument in primary care. Design. Two-stage screening design. Primary care attenders aged 65 and over were screened for generalized anxiety in the surgery with the 11-item generalized anxiety subscale of the ADS (ADS GA), a selected subsample then proceeding to a clinical validation interview. Intervention. None. Main outcome measures. Scores on the ADS GA, non-hierarchical ICD-10 caseness for generalized anxiety established by brief clinical interview by an old age psychiatrist. Results. The prevalence rate of generalized anxiety was 16% using the established cutpoint and showed an age-related decline. A cutpoint of 2-3/11 appeared to give optimal performance in this small sample (sensitivity 85%, specificity 77%. Positive predictive value 52%), suggesting that 36% of elderly general practice attenders might be diagnosed as having generalized anxiety. A reduced four-item version gave a predicted sensitivity of 77%, a specificity of 83% and a positive predictive value of 63% (cutpoint 1-2/4). Conclusions. A four-item version of the ADS GA. The FEAR (frequency of anxiety: enduring nature of anxiety; alcohol or sedative use: restlessness or fidgeting), has potential as a rapid screening instrument for use in primary care.

Note: Article Krasucki C, Inst Psychiat, Old Age Psychiat Sect, De Crespigny Pk, London SE5 8AF, ENGLAND

Keyword(s): aged; anxiety disorders; cross-sectional studies; primary health care; questionnaires; reproducibility of results; screening; DEPRESSION; PREVALENCE; AGE

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