Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Feb:20:9-15.
doi: 10.1016/j.msard.2017.12.007. Epub 2017 Dec 16.

The validity and reliability of screening measures for depression and anxiety disorders in multiple sclerosis

Ruth Ann Marrie  1 , Lixia Zhang  2 , Lisa M Lix  2 , Lesley A Graff  3 , John R Walker  3 , John D Fisk  4 , Scott B Patten  5 , Carol A Hitchon  6 , James M Bolton  7 , Jitender Sareen  7 , Renée El-Gabalawy  8 , James J Marriott  6 , Charles N Bernstein  6
Affiliations
Free article

The validity and reliability of screening measures for depression and anxiety disorders in multiple sclerosis

Ruth Ann Marrie et al. Mult Scler Relat Disord. 2018 Feb.
Free article

Abstract

Objective: We aimed to evaluate the validity and reliability of multiple screening measures for depression and anxiety for use in the clinical care of people with multiple sclerosis (MS).

Methods: Participants with MS completed the Patient Health Questionnaire (PHQ-9), Hospital Anxiety and Depression Scale (HADS), Kessler-6 Distress Scale, PROMIS Emotional Distress Depression Short-Form 8a (PROMIS Depression) and Anxiety Short-Form 8a (PROMIS Anxiety), Generalized Anxiety Disorder 7-item Scale (GAD-7), and the Overall Anxiety and Severity Impairment Scale (OASIS). A subgroup repeated the screening measures two weeks later. All participants also completed a Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID). For the screening measures we computed sensitivity, specificity, positive predictive and negative predictive value with SCID diagnoses as the reference standard and conducted receiver operating curve (ROC) analyses; we also assessed internal consistency and test-retest reliability.

Results: Of 253 participants, the SCID classified 10.3% with major depression and 14.6% with generalized anxiety disorder. Among the depression measures, the PHQ-9 had the highest sensitivity (84%). Specificity was generally higher than sensitivity, and was highest for the HADS-D with a cut-point of 11 (95%). In ROC analyses the area under the curve (AUC) did not differ between depression measures. Among the anxiety measures, sensitivity was highest for the HADS-A with a cut-point of 8 (82%). Specificity ranged from 83% to 86% for all measures except the HADS-A with a cut-point of 8 (68%). The AUC did not differ between anxiety measures.

Conclusion: Overall, performance of the depression and anxiety screening measures was very similar, with reasonable psychometric properties for the MS population, suggesting that other factors such as accessibility and ease of use could guide the choice of measure in clinical practice.

Keywords: Anxiety; Depression; Multiple sclerosis; Psychometrics; Reliability; Validity.

PubMed Disclaimer

Publication types