Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, No 8, Gongti South Road, 100020, Chaoyang District, Beijing, PR China.
Department of Clinical Psychology, Beijing Chao-Yang Hospital, Capital Medical University, No 8, Gongti South Road, 100020, Chaoyang District, Beijing, PR China.
BMC Psychiatry. 2023 Aug 15;23(1):593. doi: 10.1186/s12888-023-05072-5.
Patients with chronic obstructive pulmonary disease (COPD) often have comorbid generalized anxiety disorder (GAD), which requires early screening in respiratory clinics. The Generalized Anxiety Disorder-7 (GAD-7) questionnaire is a brief and commonly used screening tool for GAD but has not been validated among patients with COPD in China.
Stable patients with COPD from a cross-sectional observational study were assessed using the GAD-7 questionnaire and then assessed by a senior psychiatrist to confirm a diagnosis of GAD according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Demographic characteristics, spirometry, and patient-reported outcomes were collected. Cronbach's α coefficient was calculated, and receiver operating curve (ROC) analysis was performed to validate the GAD-7.
A total of 226 patients with COPD were enrolled, and 50 (22.1%) of these patients were diagnosed with GAD. The Cronbach's α coefficient for the GAD-7 was 0.869, which indicated good internal consistency. ROC curve analysis showed that the GAD-7 had an area under the curve (AUC) value of 0.829 (95% CI: 0.774-0.876) for identifying GAD. The optimal cut-off score was ≥ 4, with a sensitivity of 66.0% and a specificity of 89.2%. Higher GAD-7 scores were significantly associated with health-related quality of life and the symptom burden of COPD. The discriminatory power of GAD-7 did not differ statistically when stratified by COPD severity.
The GAD-7 was shown to be a reliable and valid screening tool for patients with COPD in China, and its screening performance for GAD was not influenced by disease severity.
慢性阻塞性肺疾病（COPD）患者常伴有共病广泛性焦虑症（GAD），这需要在呼吸科进行早期筛查。广泛性焦虑症-7 项问卷（GAD-7）是一种用于筛查 GAD 的简短且常用的工具，但尚未在中国 COPD 患者中得到验证。
一项横断面观察性研究中稳定期 COPD 患者使用 GAD-7 问卷进行评估，然后由资深精神科医生根据《精神障碍诊断与统计手册》第五版的标准进行评估，以确认 GAD 的诊断。收集人口统计学特征、肺功能和患者报告的结果。计算 Cronbach's α 系数，并进行接收者操作特征曲线（ROC）分析以验证 GAD-7。
共纳入 226 例 COPD 患者，其中 50 例（22.1%）患者被诊断为 GAD。GAD-7 的 Cronbach's α 系数为 0.869，表明内部一致性良好。ROC 曲线分析显示，GAD-7 用于识别 GAD 的曲线下面积（AUC）值为 0.829（95%CI：0.774-0.876）。最佳截断值为≥4，灵敏度为 66.0%，特异性为 89.2%。较高的 GAD-7 评分与健康相关生活质量和 COPD 症状负担显著相关。GAD-7 的区分能力在按 COPD 严重程度分层时没有统计学差异。
GAD-7 在中国 COPD 患者中是一种可靠且有效的筛查工具，其对 GAD 的筛查性能不受疾病严重程度的影响。
