CG123 Common mental health disorders - National Institute for ...

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Figure 3: Forest plot of sensitivity and specificity for ADD (GAD item),GAD-Q-IV item 2, VAS, GAD-2 and ADS-GA (three items)ADD (GAD item)Case identification and formal assessmentStudyMEANS-C2006TP30FP37GAD-Q-IV Item 2 (GAD)FN TN0 48Age group No. itemsSensitivity SpecificityAdult 1.0 1.00 [0.88, 1.00] 0.56 [0.45, 0.67]Sensitivity0 0.2 0.4 0.6 0.8 1Specificity0 0.2 0.4 0.6 0.8 1Study TPWEBB2008 86VAS (Anxiety)FP25FN TN Age group No. items24Sensitivity Specificity55 Older adult 1.0 0.78 [0.69, 0.85] 0.69 [0.57, 0.79]Sensitivity0 0.2 0.4 0.6 0.8 1Specificity0 0.2 0.4 0.6 0.8 1Study TPDENNIS2007 6BSI-Anxiety-2 itemFP11FN TN Age group No. itemsSensitivity Specificity6 17 Older adult 1.0 0.50 [0.21, 0.79] 0.61 [0.41, 0.78]Sensitivity0 0.2 0.4 0.6 0.8 1Specificity0 0.2 0.4 0.6 0.8 1Study TPLANG2009 28GAD-2 (Anxiety)FP16FN TN2391Age group No. itemsSensitivity SpecificityAdult 2.0 0.55 [0.40, 0.69] 0.85 [0.77, 0.91]Sensitivity0 0.2 0.4 0.6 0.8 1Specificity0 0.2 0.4 0.6 0.8 1StudyKROENKE2007GAD-2 (GAD)TP122FP93FNTN66 684Age group No. items Sensitivity SpecificityAdult 2.0 0.65 [0.58, 0.72] 0.88 [0.86, 0.90]Sensitivity0 0.2 0.4 0.6 0.8 1Specificity0 0.2 0.4 0.6 0.8 1StudyKROENKE2007TP63FP152ADS GA (3 items) (GAD)FNTN10 740Age group No. items Sensitivity SpecificityAdult 2.0 0.86 [0.76, 0.93] 0.83 [0.80, 0.85]Sensitivity0 0.2 0.4 0.6 0.8 1Specificity0 0.2 0.4 0.6 0.8 1StudyKRASUCKI1999TP10FP6FN TN Age group No. itemsSensitivity Specificity3 29 Older adult 3.0 0.77 [0.46, 0.95] 0.83 [0.66, 0.93]Sensitivity0 0.2 0.4 0.6 0.8 1Specificity0 0.2 0.4 0.6 0.8 1With regard to ultra-brief instruments (defined as those with one to three items),for the identification of any anxiety disorder or GAD in adults the GAD-2 had thebest diagnostic accuracy for use in primary care. For the identification of GAD inolder adults, the three-item version of the ADS-GA had the best accuracy. In secondarycare only the VAS has been evaluated, but diagnostic accuracy was poor.With regard to longer instruments (defined as those with four to 12 items), for theidentification of GAD in adults, the GAD-7 had the best diagnostic accuracy for usein primary care. For the identification of GAD in older adults, the four-item versionof the ADS-GA had the best accuracy for use in primary care. In secondary care, theGAI-SF has adequate accuracy for the identification of GAD in older people. In acommunity sample, the GAD-Q-IV had good accuracy for the identification of GADin adults. No other instrument had adequate accuracy, including the HADS-A,although, as can be seen in Figure 9, the HADS-A may have better diagnostic accuracywhen used with older adults.99
Case identification and formal assessmentFigure 4: Summary ROC plot of tests for ultra-brief instrumentsSensitivity10.90.80.70.60.50.40.30.20.1010.90.8LegendADD (GAD item)GAD-Q-IV Item 2 (GAD)VAS (Anxiety)BSI-Anxiety-2 item0.70.60.50.40.3GAD-2 (Anxiety)GAD-2 (GAD)ADS GA (3 items) (GAD)0.20.1 0Specificity5.2.6 Health economic evidenceThe systematic search of the economic literature undertaken for the guideline identifiedonly one eligible study on identification methods of postnatal depression (Hewittet al., 2009). This was an HTA and the validity (diagnostic accuracy), acceptability,100
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Commonmental healthdisordersTHE NIC
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© The British Psychological Societ
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Contents6 FURTHER ASSESSMENT OF RIS
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Guideline development group members
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Preface1 PREFACEThis guideline has
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Prefacecollaborative manner using t
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PrefaceThe experience of people wit
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Common mental health disorders2.2 T
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Common mental health disordersto ho
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Common mental health disordersManua
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Common mental health disordershighe
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Common mental health disordersNegat
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Common mental health disorderscours
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Common mental health disordersover
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Common mental health disorders2.2.6
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Common mental health disordersTable
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Common mental health disorders1996)
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Common mental health disordersSumma
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Common mental health disordersTable
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Common mental health disordersappli
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Common mental health disorderspatie
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Methods used to develop this guidel
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Further assessment of risk and need
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Systems for organising and developi
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Summary of recommendations8.1.1.6 S
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Summary of recommendationsFigure 12
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Summary of recommendations●Genera
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Summary of recommendations8.4 STEPS
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Summary of recommendations●●a g
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Summary of recommendationsDiscuss w
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Summary of recommendationsinclude p
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Appendices9 APPENDICESAppendix 1: S
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Appendix 1of a depressive disorder
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Appendix 1b) Assessment of anxiety
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Appendix 2APPENDIX 2:DECLARATIONS O
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Appendix 2Mr Mike BessantEmployment
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Appendix 2Personal non-pecuniary in
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Appendix 2Actions takenMr Rupert Su
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Appendix 2Personal family interestN
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Appendix 3APPENDIX 3:STAKEHOLDERS A
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Appendix 4ClinicalpopulationPeople
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Appendix 4Case identificationNo. Pr
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Appendix 5APPENDIX 5:REVIEW PROTOCO
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Appendix 7APPENDIX 7:METHODOLOGY CH
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Appendix 9APPENDIX 9:METHODOLOGY CH
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Appendix 92.10 Are all important pa
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Appendix 9case also excludes costs
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Appendix 9For consistency, the EQ-5
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Appendix 9Answer ‘yes’ if the a
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Appendix 9Answer ‘yes’ if the e
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Appendix 9Answer ‘yes’ if appro
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Appendix 10APPENDIX 10: EVIDENCE TA
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Appendix 11APPENDIX 11:HIGH PRIORIT
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Appendix 11discussion of options bu
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Appendix 13APPENDIX 13:GENERALIZED
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ReferencesAndlin-Sobocki, P., Jöns
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ReferencesBower, P., Gilbody, S., R
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ReferencesCooper, S., Smiley, E., M
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ReferencesEhlers A., Gene-Cos N. &
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ReferencesGiles, D. E., Jarrett, R.
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ReferencesHorowitz, M. J., Wilner,
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ReferencesKnapp, M. & Ilson, S. (20
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ReferencesMarks, J., Goldberg, D. P
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ReferencesNCCMH (forthcoming) Self-
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ReferencesOzer, E. J., Best, S. R.,
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ReferencesSartorius, N. (2002) Eine
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ReferencesTiemens, B. G., Ormel, J.
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ReferencesWilkinson, M. J. B. & Bar
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Glossarybeliefs and interpretations
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Glossaryto learn to become more awa
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Abbreviations12 ABBREVIATIONSADDADS
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AbbreviationsOASISOCDONSORPHQ (-A,
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