The development of brief, patient completed scales to screen for psychiatric disorders has been stimulated by the needs of busy practitioners and the necessity to ensure diagnostic accuracy and measures of change. In the assessment of depression, the 7 item version of the Hamilton Depression Rating Scale1 has been introduced as a brief and accurate scale for measuring the severity of depressed mood.
Anxiety disorders present a complex problem given the large number of disorders it includes. Scales have been developed for the assessment of social anxiety disorder (SAD)2 and a 3 item scale was shown to be a reliable method for identifying patients with SAD.3 Spitzer at al reported the development of a brief 7 item screening tool
to assess the presence of GAD in a primary care population. The scale does not provide for a definitive diagnosis of GAD but presents a rapid, efficient, reliable, and valid method for detecting the presence of a common anxiety disorder. Most busy mental health and primary care practitioners probably do not follow the rigorous questioning required by the DSM-IV to diagnose GAD and to rule out other anxiety disorders characterised by persistent worry. The GAD-7 scale will be a useful
screening tool that can identify GAD when it presents as an anxiety disorder and when it is comorbid with depressive disorders. Future studies examining the reliability of the GAD-7 scale in the assessment of comorbid anxiety disorders will be of great interest and value.
Richard P Swinson, MD
Hamilton, Ontario, Canada
1 McIntyre R, Kennedy S, Bagby RM, et al. Assessing full remission. J
Psychiatry Neurosci 2002;27:235–9.
2 Connor KM, Davidson JR, Churchill LE, et al. Psychometric properties of the
Social Phobia Inventory (SPIN). New self-rating scale. Br J Psychiatry
3 Connor KM, Kobak KA, Churchill LE, et al. Mini-SPIN: A brief screening
assessment for generalized social anxiety disorder. Depress Anxiety
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