Evaluating the GAD-2 to screen for post-stroke anxiety on an acute stroke unit

Post stroke anxiety is associated with reduced quality of life, worse rehabilitation outcomes and poor social functioning in stroke survivors. Despite its clinical relevance, there are a lack of screening tools to identify post-stroke anxiety. The Hospital Anxiety and Depression Scale (HADS-A) and G...

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Bibliographic Details
Published in:Neuropsychological rehabilitation 2023-04, Vol.33 (3), p.480-496
Main Authors: McCrory, Meghan, Murphy, Donnchadh F., Morris, Reg C., Noad, Rupert F.
Format: Article
Language:English
Subjects:
Aged
Anxiety
Anxiety - diagnosis
Anxiety - etiology
Anxiety disorders
Anxiety Disorders - diagnosis
Anxiety Disorders - etiology
Clinical assessment
Cognitive ability
Convergent validity
Depression - diagnosis
GAD-2
Generalized anxiety disorder
Humans
Medical screening
Patient Health Questionnaire
Patients
Psychiatric Status Rating Scales
Psychometrics
Quality of Life
Rehabilitation
Reproducibility of Results
Retrospective Studies
Screening
Self report
Sensitivity and Specificity
Social functioning
Stroke
Stroke - complications
Stroke - psychology
Test anxiety
Validation
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Summary:Post stroke anxiety is associated with reduced quality of life, worse rehabilitation outcomes and poor social functioning in stroke survivors. Despite its clinical relevance, there are a lack of screening tools to identify post-stroke anxiety. The Hospital Anxiety and Depression Scale (HADS-A) and Geriatric Anxiety Inventory (GAI) are the only self-report screening test for anxiety validated in stroke patients. However, both of these measures have limitations associated with their clinical utility, length of time to administer and cost to purchase. This study aimed to assess the classiciation accuracy of a freely available and shorter alternative, the Generalized Anxiety Disorder 2-item (GAD-2) for use in the acute stroke setting. This study used retrospective analysis of a sequential sample in a clinical database of mood and cognitive scores. Patients' scores on the GAD-2 and HADS-A were compared. The GAD-2 demonstrated strong convergent validity with the HADS-A and good specificity and sensitivity for clinical anxiety. In conclusion, the GAD-2 may be a useful screening assessment of post-stroke anxiety in the acute setting; however, it should be used with due consideration of the methodological limitations of this study.
ISSN:0960-2011
1464-0694
DOI:10.1080/09602011.2022.2030366