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Prevalence of depressive and anxiety disorders and validation of the Hospital Anxiety and Depression Scale as a screening tool in axial spondyloarthritis patients
Author(s) -
Chan Cynthia Y. Y.,
Tsang Helen H. L.,
Lau C. S.,
Chung H. Y.
Publication year - 2017
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.12456
Subject(s) - hospital anxiety and depression scale , anxiety , medicine , depression (economics) , major depressive disorder , psychiatry , mood , economics , macroeconomics
Objective To determine the prevalence of anxiety and depression in axial spondyloarthritis (SpA) patients by a psychiatrist using the Chinese‐bilingual Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders , fourth edition patient research version ( CB ‐ SCID ‐I/P), and to examine the effectiveness of the Hospital Anxiety and Depression Scale ( HADS ) as a screening tool. Methods We recruited 160 Chinese axial‐SpA patients to determine the prevalence of anxiety and depression using the CB ‐ SCID ‐I/P. Recruited subjects were asked to complete the HADS . HADS , HADS ‐depression ( HADS ‐D) subscale and HADS ‐anxiety ( HADS ‐A) subscale were analyzed to determine their effectiveness in screening for depressive and anxiety disorders. Results The prevalence of current major depressive disorder ( MDD ) and anxiety disorder were 10.6% and 15.6%, respectively. The full‐scale HADS outperformed the HADS ‐D subscale in screening for current MDD (area under the curve [ AUC ] 0.889; 0.844) and all depressive disorders ( AUC 0.885; 0.862) while the HADS ‐A subscale outperformed the full scale HADS in screening for anxiety disorders ( AUC 0.894; 0.846). The optimal cut‐off point of the full scale HADS for screening current MDD and all depressive disorders were 7/8 and 6/7, yielding a sensitivity of 82.4% and 83.9%, specificity of 78.7% and 74.8%, respectively. The optimal cut‐off point of HADS ‐A subscale for screening anxiety disorders was 6/7, yielding a sensitivity of 88.0% and specificity of 74.4%. Conclusion The prevalence of MDD and anxiety disorder in SpA patients were 10.6% and 15.6%, respectively. We recommend using the full‐scale HADS in screening for depressive disorders and HADS ‐A subscale for anxiety disorders.