The FEAR: a rapid screening instrument for generalized anxiety in elderly primary care attenders.
OBJECTIVE
To develop a shorter version of the Anxiety Disorder Scale (ADS) for use as a rapid screening instrument in primary care.


METHODS
Two-stage screening design. Primary care attenders aged 65 and over were screened for generalized anxiety in the surgery with the 11-item generalized anxiety subscale of the ADS (ADS GA), a selected subsample then proceeding to a clinical validation interview.


METHODS
None.


METHODS
Scores on the ADS GA, non-hierarchical ICD-10 caseness for generalized anxiety established by brief clinical interview by an old age psychiatrist.


RESULTS
The prevalence rate of generalized anxiety was 16% using the established cutpoint and showed an age-related decline. A cutpoint of 2-3/11 appeared to give optimal performance in this small sample (sensitivity 85%, specificity 77%, positive predictive value 52%), suggesting that 36% of elderly general practice attenders might be diagnosed as having generalized anxiety. A reduced four-item version gave a predicted sensitivity of 77%, a specificity of 83% and a positive predictive value of 63% (cutpoint 1-2/4).


CONCLUSIONS
A four-item version of the ADS GA, the FEAR (frequency of anxiety; enduring nature of anxiety; alcohol or sedative use; restlessness or fidgeting), has potential as a rapid screening instrument for use in primary care.
Institute of Psychiatry, London, UK.
C
C
Krasucki
P
P
Ryan
T
T
Ertan
R
R
Howard
J
J
Lindesay
A
A
Mann
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology; D001008:Anxiety Disorders / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D005260:Female; D006299:Health Services for the Aged; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D011320:Primary Health Care; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D012680:Sensitivity and Specificity