Escala de ansiedad generalizada GAD-7 en profesionales médicos colombianos durante pandemia de COVID-19: validez de constructo y confiabilidad

Introducción: La detección de síntomas de ansiedad entre el personal sanitario que atiende a pacientes contagiados de COVID-19 es una prioridad actual. Se requieren instrumentos rápidos y válidos para esta población. El objetivo es establecer la validez de constructo y la confiabilidad de la Escala de Ansiedad Generalizada (GAD-7) en médicos colombianos durante la cuarentena por la COVID-19. Métodos: Estudio eSalud, en el que se recopilaron datos transversales en línea (n = 1.030) de 610 médicos de COVID y 420 no de COVID durante la cuarentena colombiana, entre el 20 de abril y el 10 de agosto de 2020. Se contactó con cada sujeto, que confirmó participación, identidad y función profesional. Resultados: Se encontró una estructura factorial de 1 solo factor, conformado por los 7 ítems del instrumento, que logró explicar el 70% de la varianza. Los índices de bondad de ajuste (RMSEA = 0,080; CFI = 0,995; SRMR = 0,053; p 0,07. Por último, la consistencia interna del instrumento fue buena, con alfa de Cronbach = 0,920 (IC95%,8,80-9,71). Conclusiones: El GAD-7 es un instrumento que presenta indicadores adecuados de validez y confiabilidad. Es un excelente instrumento, confiable, fácil y rápido de usar para la detección de los síntomas de ansiedad generalizada en personal médico, atienda o no a pacientes contagiados de COVID-19.

Introduction: The detection of anxiety symptoms among health workers who care for patients infected with COVID-19 is a current priority. Fast and valid instruments are required for this population group. The objective is to establish the construct validity and reliability of the Generalized Anxiety Disorder (GAD-7) scale in Colombian doctors during the COVID-19 lockdown. Methods: E-health study, in which cross-sectional data were collected online (n = 1,030) from 610 COVID doctors and 420 non-COVID doctors, during the Colombian lockdown, between 20 April and 10 August 2020. Each subject was contacted, and they confirmed their participation, identity and professional role. Results: A single factor factorial structure was found, made up of the 7 items of the instrument, which managed to explain 70% of the variance. The goodness of fit indices (RMSEA = 0.080; CFI = 0.995; SRMR = 0.053; p 0.070. Finally, the internal consistency of the instrument was good, with a Cronbach's alpha of 0.920 (95%IC, 8.80-9.71). Conclusions:The GAD-7 is an instrument that presents adequate indicators of validity and reliability. It is an excellent tool that is reliable and easy and fast to use for the detection of generalised anxiety symptoms in medical personnel caring (or not) for patients infected with COVID-19.

Impacto de la presencia de depresión y ansiedad en pacientes con artritis psoriásica / Impact of depression and anxiety in patients with psoriatic arthritis

Introducción: un tercio de los pacientes con artritis psoriásica (APs) sufre ansiedad y/o depresión, lo que podría impactar negativamente en la actividad de la enfermedad. Los objetivos de este estudio fueron: evaluar la prevalencia de depresión y ansiedad en pacientes con APs, estudiar su asociación con diferentes factores sociodemográficos y clínicos, y determinar el efecto sobre los diferentes componentes de los índices compuestos de la actividad de la APs. Materiales y métodos: se incluyeron pacientes con APs que cumplían criterios de la Classification criteria of psoriatic arthritis (CASPAR). La depresión se definió según el Patient Health Questionnaire-9 (PHQ-9) y la ansiedad según el cuestionario General Anxiety Disorder-7 (GAD-7). Se realizó regresión logística múltiple para identificar variables asociadas a ansiedad y depresión. Resultados: se incluyeron 100 pacientes con APs, de los cuales el 26% y el 59% presentaron depresión mayor y ansiedad respectivamente. Los pacientes con depresión mayor tuvieron mayor actividad de la enfermedad, dolor, fatiga, ansiedad, y menor educación formal y peor calidad de vida. Aquellos con ansiedad manifestaron mayor actividad de la enfermedad, dolor y fatiga, y peor calidad de vida y capacidad funcional. La alta actividad de la enfermedad y la menor educación formal se asociaron independientemente con depresión mayor. Conclusiones: la presencia de depresión mayor y ansiedad se asoció con mayor actividad de la enfermedad en pacientes con APs.

Introduction: nearly one-third of psoriatic arthritis (PsA) patients suffer from anxiety and/or depression. The objectives of this study were to estimate the prevalence of depression and anxiety in patients with PsA, establish the relationship with different socio-demographic and clinical factors, and determine the effect of depression and anxiety on various components of disease activity scores. Materials and methods: patients with PsA who met the Classification criteria of psoriatic arthritis (CASPAR) criteria were included. Depression was defined according to the Patient Health Questionnaire-9 (PHQ-9) and anxiety according to the General Anxiety Disorder-7 (GAD-7) questionnaire. Multiple logistic regression was performed to identify variables associated with anxiety and depression. Results: 100 patients were included. The prevalence of major depression and anxiety was 26% and 59%, respectively. Patients with major depression had higher disease activity, pain, fatigue and anxiety, less formal education and worse quality of life. In comparison those patients with anxiety showed higher disease activity, pain and fatigue and worse quality of life and functional capacity. High disease activity and low formal education were independently associated with the existence of major depression. Conclusions: patients with PsA who suffer from major depression and anxiety show higher disease activity levels.

Prevalence and influencing factors of anxiety status among elderly hypertensive patients in a district of Shanghai / 四川精神卫生

ObjectiveTo analyze the anxiety status among elderly hypertensive patients in Hongkou district of Shanghai city， and to screen the influencing factors. MethodsConvenience sampling method was adopted to enroll 265 hypertensive patients aged 60 years or above from 8 communities in Hongkou district of Shanghai city， and Generalized Anxiety Disorder-7 item （GAD-7） was used to assess their anxiety status， then Logistic regression analysis was applied to explore the influencing factors. ResultsAmong 265 patients with hypertension， 45 patients （17.0%） had anxiety symptoms. Multivariate Logistic regression analysis showed that non-hypertensive chronic disease comorbidity in recent six months （OR=3.093， 95% CI： 1.075~8.898， P<0.05）， excessive alcohol consumption （OR=5.203， 95% CI： 1.407~19.234， P<0.05）， living with spouse （OR=0.061， 95% CI： 0.005~0.699， P<0.05） and regular exercise （OR=0.360， 95% CI： 0.167~0.775， P<0.01） were the factors affecting anxiety in hypertensive patients. ConclusionAnxiety symptoms are quite common among elderly hypertensive patients in community，among which comorbidities and excessive alcohol consumption are risk factors， while living with spouse and regular exercise are protective factors.

The effect of COVID-19 pandemic on anxiety disorders among workers in a hospital in Balikpapan, East Kalimantan

INTRODUCTION@#During the global COVID-19 pandemic, health workers were found to have a higher prevalence of anxiety disorder compared to non-health workers. Anxiety disorder that occurs chronically have a 25% chance to become a major depression disorder.@*OBJECTIVE@#The aim of this study is to understand the anxiety condition and related risk factors among workers in a Balikpapan hospital during the COVID-19 pandemic.@*METHOD@#The design of this research used a cross sectional method that involved 279 respondents who are workers in a Balikpapan hospital. The study used SPSS version 20.0, using the chi square and Fisher’s Exact test for the bivariate analysis, and the logistic regression with enter method for the multivariate analysis.@*RESULTS@#The study shows that using the General Anxiety Disorder 7 (GAD-7) questionnaire from 279 hospital workers, there were 10.8% with mild-, 1.45% with moderate-, and 0.4% with severe anxiety disorder. A significant relation was found between anxiety disorder and risk factors such as being a health worker with p=0.001 and a 4.8 OR adj (95% CI: 1.9-12.3), working in areas with high risk of transmitting COVID-19 with p=0.04 and a 5.1 OR adj (95% CI: 1.0-24.2), and workers who are being quarantined with p=0.001 a 10.5 OR adj (2.6-42.3) after being adjusted by age and gender variables.@*CONCLUSION@#Significant relations were found between anxiety disorder among hospital workers with risk factors such as being health workers, working in areas with high risk of transmitting COVID-19, and workers who are being quarantined. Researchers strongly advise health providers to do regular monitoring and seek moral support especially for workers who have higher risk of anxiety disorder.

Prevalencia de Trastorno de Ansiedad Generalizada según el Trimestre de Embarazo / Prevalence of Generalized Anxiety Disorder according to the Trimester of Pregnancy

Introducción: El trastorno de ansiedad generalizado (TAG) es una entidad clínica caracterizada por preocupación excesiva y no controlada que puede causar discapacidad funcional, durante un período mínimo de 6 meses. La prevalencia global de TAG en las pacientes en estado de gestación es de 8.5% a 10.5%, la cual es mayor en comparación a la población general (reportada de 1.2% a 6.4%). Entre los factores de riesgo se incluyen: bajo nivel educacional y socioeconómico, pobreza, desintegración familiar, etc. Se ha reportado como complicaciones de TAG durante el embarazo: incremento de consumo de alcohol, riesgo de parto pre término, bajo peso al nacer, etc. Objetivo: Determinar la prevalencia de trastorno de ansiedad generalizada según el trimestre de embarazo en mujeres gestantes de San Juan Sacatepéquez ya que no existen datos de dicha población. Metodología: Se empleó la escala GAD-7. Se escogió como población a pacientes que asistieron a la consulta externa del Centro de Salud Bárbara durante el mes de junio del 2018. Resultados: La prevalencia de TAG hallada fue: 7.40% en el primer trimestre, 8.82% en el segundo trimestre y 7.31% en el tercer trimestre. Palabras Clave: Ansiedad generalizada, embarazo GAD-7.

Introduction: Generalized anxiety disorder (GAD) is a clinical entity characterized by excessive and uncontrolled worry that can lead to functional disability, for a minimum period of 6 months. The global prevalence of GAD in pregnant patients is from 8.5% to 10.5%, which is higher compared to the general population (reported from 1.2% to 6.4%). Risk factors include: low educational and socioeconomic level, poverty, family disintegration, etc. It has been reported as complications of GAD during pregnancy: Increased consumption of alcohol, risk of preterm birth, low birth weight, etc. Objective: To determine the prevalence of generalized anxiety disorder according to the trimester of pregnancy in pregnant women from San Juan Sacatepéquez, since there are no data for this population. Methodology: the GAD-7 scale was used. Patients attending the outpatient clinic of the Barbara Health Center were selected as a population during the month of June 2018. Results: The prevalence of GAD found was: 7.40% in the first trimester, 8.82% in the second trimester and 7.31% in the third trimester. Keywords: General anxiety, pregnancy, GAD-7

Application of GAD-7 in population screening for generalized anxiety disorder / 中华全科医师杂志

Generalized anxiety disorder (GAD) is one of the most common anxiety disorders.However,the diagnosis of GAD is difficult,GAD has the lowest diagnostic reliability among anxiety disorders and is often neglected.This article reviews the application of the General Anxiety Disorder-7 (GAD-7) in population screening for GAD,focusing on its history of development and the scope of unilization.

Estrutura fatorial, fidedignidade e parâmetros de itens da versão em português brasileiro do questionário GAD-7 / Factor structure, reliability, and item parameters of the brazilian-portuguese version of the GAD-7 questionnaire / Estructura factorial, confiabilidad, y ítems parámetros de la versión de portugués brasileño del cuestionario GAD-7

This study examined the psychometric properties of the Brazilian-Portuguese version of the Generalized Anxiety Disorder GAD-7 questionnaire in a community sample (n = 206) of Brazilian adults. The sample was 41% female, with a mean age of 21.10 (SD = 4.49),75.6% from colleges/universities. Results of a confirmatory factor analysis provided support to the original unidimensional model of the GAD-7 in the Brazilian context. Analyses of Variance (ANOVA) showed that the GAD-7 scores were significantly different between males and females, with females scoring higher than males. The scale demonstrated good reliability evidence; both Cronbach's alpha coefficient (α = .916) and rho composite reliability coefficient (ρ= .909) were adequate. Item parameter analysis showed items 5 and 7 presented the highest severity thresholds for the generalized anxiety latent trait, whereas item 1 presented the lowest ones. Our findings suggest that the Brazilian-Portuguese version of the GAD-7 is suitable for assessing Generalized Anxiety Disorder symptoms in Brazilian adults in community settings.

Este estudo analisou as propriedades psicométricas da versão em Português Brasileiro do questionário de "Transtorno de Ansiedade Generalizada - GAD-7 em uma amostra de comunidade (n = 206) da população adulta brasileira. A amostra foi composta por de 41% de participantes do sexo feminino, com idade média de 21,10 (DP = 4,49), e 75,6% em instituições de ensino superior. Os resultados da análise fatorial confirmatória forneceram apoio para o modelo unidimensional original do GAD-7 no contexto brasileiro. As análises de variância (ANOVA) mostraram que os escores do GAD-7 foram significativamente diferentes entre homens e mulheres, com as mulheres apresentando maiores escores que os homens. A escala demonstrou uma boa fidedignidade; sendo que tanto o coeficiente de Cronbach alfa (α = 0,916) e rho coeficiente de confiabilidade composta (ρ = 0,909) foram adequados. A análise dos parâmetros dos itens mostrou itens 5 e 7 apresentaram os limiares mais elevados de severidade para o traço-latente de ansiedade generalizada, enquanto que o item 1 apresentou as menores. Nossos resultados sugerem que a versão Português Brasileiro do GAD-7 é adequada para avaliar os sintomas do transtorno de ansiedade generalizada em adultos brasileiros em ambientes comunitários.

Este estudio examinó las propiedades psicométricas de la versión de portugués brasileño del cuestionario de Desorden de Ansiedad Generalizada GAD-7, en una muestra comunitaria (n = 206) de adultos brasileños. La muestra se compone de 41% de mujeres, con una edad media de 21,10 (SD = 4,49), y 75,6% estudiantes universitarios. El análisis factorial confirmatorio proporcionó evidencias que soportan el modelo unidimensional original del GAD-7 en el contexto brasileño. El análisis de variancia (ANOVA) mostró que las puntuaciones fueron significativamente diferentes entre hombres y mujeres, siendo que las mujeres obtuvieron puntuaciones más altas que los hombres. La escala demostró tener una buena confiabilidad; el coeficiente de alpha de Cronbach (α= .916) y el coeficiente rho de fiabilidad (ρ = .909) fueron adecuados. El análisis de datos mostró los ítems 5 y 7 tuvieron los umbrales de gravedad más altos en el trazo de ansiedad generalizada, mientras el ítem 1 tuvo el más bajo. Nuestros hallazgos sugieren que la versión en portugués brasileño de GAD-7 es adecuado para la evaluación de síntomas de trastorno de ansiedad generalizada en adultos brasileños en contextos comunitarios.