Hostname: page-component-77f85d65b8-8wtlm Total loading time: 0 Render date: 2026-04-17T10:15:50.035Z Has data issue: false hasContentIssue false
  • English
  • Français

Sensitivity and specificity of the Geriatric Anxiety Inventory and the Hospital Anxiety and Depression Scale in the detection of anxiety disorders in older people with chronic obstructive pulmonary disease

Published online by Cambridge University Press:  28 July 2011

Gary Cheung ,
Colin Patrick ,
Glenda Sullivan ,
Manisha Cooray  and
Catherina L. Chang
Gary Cheung*
Affiliation:
Mental Health Services for Older People, Auckland District Health Board, Auckland, New Zealand
Colin Patrick
Affiliation:
Mental Health Services for Older People, Waikato District Health Board, Hamilton, New Zealand
Glenda Sullivan
Affiliation:
Department of Respiratory Medicine, Waikato District Health Board, Hamilton, New Zealand
Manisha Cooray
Affiliation:
University of Auckland, New Zealand
Catherina L. Chang
Affiliation:
Department of Respiratory Medicine, Waikato District Health Board, Hamilton, New Zealand
*
Correspondence should be addressed to: Dr Gary Cheung, Greenlane Clinical Centre, Private Bag 92189, Auckland, New Zealand. Phone: + 64 9 6236474; Fax: + 64 9 6236475. Email: GCheung@adhb.govt.nz.
Get access

Abstract

Background: Anxiety and depression are prevalent in patients with chronic obstructive pulmonary disease (COPD). This study evaluates the sensitivity and specificity of two self-administered anxiety rating scales in older people with COPD. The Geriatric Anxiety Inventory (GAI) and the Hospital Anxiety and Depression Scale (HADS) are established useful screening tools but they have not been previously validated in this population.

Methods: Older people with COPD completed the GAI and the HADS along with a structured diagnostic psychiatric interview, the Mini International Neuropsychiatric Interview (MINI). The outcomes of both rating scales were compared against the diagnosis of anxiety disorders based on the MINI. Receiver operating characteristic (ROC) curves were used to identify the optimal diagnostic cut points for each scale.

Results: Fourteen (25.5%) of the 55 participants, were diagnosed with an anxiety disorder. Mean GAI and HADS-anxiety subscale scores were significantly higher in subjects with an anxiety disorder than those without the diagnosis (p = 0.002 and 0.005 respectively). Both scales demonstrated moderate diagnostic value (area under the ROC curve was 0.83 for GAI and 0.79 for HADS). Optimal cut points were ≥3 (GAI) and ≥4 (HADS-anxiety subscale). At these cut-points, the GAI had a sensitivity of 85.7%, specificity of 78.0% and the HADS had a sensitivity of 78.6%, specificity 70.7%.

Conclusion: Our results support the use of the GAI and HADS as screening instruments for anxiety disorders in older people with COPD. The optimal cut points in this population were lower than previously recommended for both rating scales. The results of this study should be replicated before these cut points can be recommended for general use in older people with COPD.

Keywords

chronic obstructive pulmonary diseaseanxietyolder peopleGeriatric Anxiety InventoryHospital Anxiety and Depression Scale

Information

Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 1 , January 2012 , pp. 128 - 136
Copyright
Copyright © International Psychogeriatric Association 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Asthma and Respiratory Foundation of New Zealand (2001). COPD (Chronic Obstructive Pulmonary Disease) at a Glance. Available at https://www.asthmafoundation.org.nz/files/WordDocs/Resources/Fact_sheets/COPD_ataGlance.doc.Google Scholar
Ballenger, J., Davidson, J. and Lecrubier, Y. (2001). Consensus statement on generalized anxiety disorder from the International Consensus Group on Depression and Anxiety. Journal of Clinical Psychiatry, 62 (Suppl. 11), 53–38.Google Scholar
Bertani, A., Perna, G. and Arancio, C. (1997). Pharmacologic effect of imipramine, paroxetine, and sertraline on 35% carbon dioxide hypersensitivity in panic patients: a double-blind, random, placebo-controlled study. Journal of Clinical Psychopharmacology, 17, 97–101.CrossRefGoogle ScholarPubMed
Bjelland, I., Dahl, A. A., Haug, T. T. and Neckelmann, D. (2002). The validity of the Hospital Anxiety and Depression Scale: an updated literature review. Journal of Psychosomatic Research, 52, 69–77.CrossRefGoogle ScholarPubMed
Boddice, G. and Pachana, N. A. (2008). The Clinical utility of the geriatric anxiety inventory in older adults with cognitive impairment. Nursing Older People, 20, 36–39.CrossRefGoogle ScholarPubMed
Brenes, G. (2003). Anxiety and chronic obstructive pulmonary disease: prevalence, impact and treatment. Psychosomatic Medicine, 65, 963–970.CrossRefGoogle ScholarPubMed
Byrne, G. J. A. and Pachana, N. A. (2011). Development and validation of a short form of the Geriatric Anxiety Inventory: the GAI-SF. International Psychogeriatrics, 23, 125–131.CrossRefGoogle Scholar
Chang, C. et al. (2007). Audit of acute admissions of chronic obstructive pulmonary disease: inpatient management and outcome. Internal Medicine Journal, 37, 236–241.CrossRefGoogle ScholarPubMed
Cheung, G. (2007). Concurrent validity of the Geriatric Anxiety Inventory in late-life depression. International Psychogeriatrics, 19, 333–335.CrossRefGoogle ScholarPubMed
Davies, K. N., Burn, W. K., McKenzie, F. R., Brothwell, J. A. and Wattis, J. P. (1993). Evaluation of the Hospital Anxiety and Depression Scale as a screening instrument in geriatric medical inpatients. International Journal of Geriatric Psychiatry, 8, 165–169.CrossRefGoogle Scholar
Dennis, R. E. and Boddington, S. J. A. (2007). Self-report measures of anxiety: are they suitable for older adults? Aging and Mental Health, 11, 668–677.CrossRefGoogle ScholarPubMed
Dowson, C., Laing, R. and Barraclough, R. (2001). The use of the Hospital Anxiety and Depression Scale in patients with chronic obstructive pulmonary disease: a pilot study. New Zealand Medical Journal, 114, 447–449.Google ScholarPubMed
Gudmundsson, G. et al. (2006). Depression, anxiety and health status after hospitalisation for COPD: a multicentre study in the Nordic countries. Respiratory Medicine, 2006, 100, 87–93.CrossRefGoogle ScholarPubMed
Klein, D. (1993). False suffocation alarms, spontaneous panics, and related conditions: an integrative hypothesis. Archives of General Psychiatry, 50, 306–317.CrossRefGoogle ScholarPubMed
Kunik, M. et al. (2005). Surprisingly high prevalence of anxiety and depression in chronic breathing disorders. Chest, 127, 1205–1211.Google ScholarPubMed
Lam, C. L., Pan, P. C., Chan, A. W., Chan, S. Y. and Munro, C. (1995). Can the Hospital Anxiety and Depression (HAD) Scale be used on Chinese elderly in general practice? Family Practice, 12, 149–154.CrossRefGoogle ScholarPubMed
Ley, R. (1989). Dyspnoeic-fear and catastrophic cognitions in hyperventilatory panic attacks. Behaviour Research and Therapy, 5, 549–554.CrossRefGoogle Scholar
Maurer, J. et al. (2008). Anxiety and depression in COPD: current understanding, unanswered questions and research needs. Chest, 134, 43–56.CrossRefGoogle ScholarPubMed
Matheson, S. et al. (2010). Validity and reliability of the Geriatric Anxiety Inventory in Parkinson's disease. Australasian Journal on Ageing. Epublished ahead of print, doi: 10.111/j.1741–6612.2010.00487.x.Google Scholar
Muller, J., Koen, L. and Stein, D. (2005). Anxiety and medical disorders. Current Psychiatry Reports, 7, 245–251.CrossRefGoogle ScholarPubMed
National Institute for Clinical Excellence (2004). Chronic Obstructive Pulmonary Disease: Management of Chronic Obstructive Pulmonary Disease in Adults in Primary and Secondary Care. Clinical guideline 12. Available at http://www.nice.org.uk/CG012NICEguideline.Google Scholar
Pachana, N., Byrne, G. and Siddle, H. (2007). Development and validation of the Geriatric Anxiety Inventory. International Psychogeriatrics, 19, 103–114.CrossRefGoogle ScholarPubMed
Shanmugam, G., Bhutani, S., Khan, D. A. and Brown, E. S. (2007). Psychiatric considerations in pulmonary disease. Psychiatric Clinics of North America, 30, 761–780.CrossRefGoogle ScholarPubMed
Sheehan, D. et al. (1998). The Mini-International Neuropsychiatric Interview (MINI): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry, 59 (Suppl. 20), 22–57.Google ScholarPubMed
Thoracic Society of Australia and New Zealand and Australian Lung Foundation (2002). Chronic Obstructive Pulmonary Disease (COPD). Australian and New Zealand Management Guidelines and the COPD Handbook. Available at http://www.nzgg.org.nz/guidelines/0073/COPDHandbook.pdf.Google Scholar
Yohannes, A., Baldwin, R. and Connolly, M. (2000a). Depression and anxiety in elderly outpatients with chronic obstructive pulmonary disease: prevalence, and validation of the BASDEC screening questionnaire. International Journal of Geriatric Psychiatry, 15, 1090–1096.3.0.CO;2-L>CrossRefGoogle ScholarPubMed
Yohannes, A., Baldwin, R. and Connolly, M. (2000b). Mood disorders in elderly patients with chronic obstructive pulmonary disease. Reviews in Clinical Gerontology, 10, 193–202.CrossRefGoogle Scholar
Yohannes, A., Baldwin, R. and Connolly, M. (2003). Prevalence of sub-threshold depression in elderly patients with chronic obstructive pulmonary disease. International Journal of Geriatric Psychiatry, 18, 412–416.CrossRefGoogle ScholarPubMed
Zigmond, A. and Snaith, R. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67, 361–370.CrossRefGoogle ScholarPubMed